| Vitality Family Healthcare, Llc | |
|
1028 N Webb Rd Ste E Grand Island NE 68803-3318 | |
| (308) 865-0703 | |
| (308) 865-0703 |
| Full Name | Vitality Family Healthcare, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1028 N Webb Rd Ste E, Grand Island, Nebraska |
| Authorized Official Name and Position | Jacob Christopher Peterson (CEO, PHYSICIAN) |
| Authorized Official Contact | 3088650703 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vitality Family Healthcare, Llc 521 West Ave Holdrege NE 68949-2226 Ph: (308) 865-0703 | Vitality Family Healthcare, Llc 1028 N Webb Rd Ste E Grand Island NE 68803-3318 Ph: (308) 865-0703 |
| NPI Number | 1851097406 |
|---|---|
| Provider Enumeration Date | 02/06/2023 |
| Last Update Date | 02/06/2023 |
| Medicare PECOS PAC ID | 8022480151 |
|---|---|
| Medicare Enrollment ID | O20230217001572 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851097406 | NPI | - | NPPES |
| Provider Name | Jacob C Peterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679954028 PECOS PAC ID: 5294040275 Enrollment ID: I20180507000732 |
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