| NPI | 1912001017 |
|---|---|
| Doing Business As | MAIN STREET VITAL CARE |
| Entity Type | Organization |
| Authorized Contact | CHRISTY R NEWBAKER Owner 731-627-2221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TN 0000000895) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: TN 0000000895) |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: TN 0000000895) | |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: TN 0000000895) | |
| 333600000X Pharmacy (Licence: TN 0000000895) | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TN 0000000895) | |
| 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy (Licence: TN 0000000895) | |
| 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: TN 0000000895) | |
| 3336M0002X Pharmacy, Mail Order Pharmacy (Licence: TN 0000000895) | |
| 3336S0011X Pharmacy, Specialty Pharmacy (Licence: TN 0000000895) | |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2008-04-20 |