NEW VITALIS, LLC NPI 1801345111

Pharmacy (Compounding Pharmacy) in Louisville, KY

NPI 1801345111 Organization Pharmacy Compounding Pharmacy

About NEW VITALIS, LLC

New Vitalis, Llc is a provider established in Louisville, Kentucky specializing in pharmacy (compounding pharmacy) . The NPI number of New Vitalis, Llc is 1801345111 and was assigned on September 2016. The practitioner's primary taxonomy code is 3336C0004X with license number P07786 (KY). The provider is registered as an organization and their NPI record was last updated 5 years ago. The authorized official of this NPI record is Mr. Ted Ennenbach (Ceo)

NPI

1801345111

Provider NameNEW VITALIS, LLC
Provider Location Address4139 CADILLAC CT SUITE 201 LOUISVILLE, KY 40213
Provider Mailing Address9600 BROWNSBORO RD SUITE 200 LOUISVILLE, KY 40241
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?Yes
Enumeration Date09-27-2016
Last Update Date09-27-2016


Primary Taxonomy

Taxonomy Code3336C0004X
ClassificationPharmacy
TypeSuppliers
SpecializationCompounding Pharmacy
License No.P07786
License StateKY
Taxonomy DescriptionA pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice.

Business Address

NEW VITALIS, LLC
4139 CADILLAC CT
SUITE 201
LOUISVILLE, KY
ZIP 40213
Phone: (502) 425-0500

Get Directions


Mailing Address

NEW VITALIS, LLC
9600 BROWNSBORO RD
SUITE 200
LOUISVILLE, KY
ZIP 40241
Phone:



Authorized Official

Authorized Official NameMR. TED ENNENBACH
Authorized Official TitleCEO
Authorized Official Phone(502) 425-0500

Other Providers at the same location


The following 4 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1457457798HOUSECALLS OF AMERICA, INC.
Organization
Home Health4139 CADILLAC CT SUITE 100
LOUISVILLE, KY 40213
(502) 238-5150
1760607022 ROBERT I ORENDORF PT
Individual
Physical Therapist4139 CADILLAC CT
LOUISVILLE, KY 40213
(502) 238-5150
1629528641DR. MICHAEL JESSE KELLIHAN PHARM.D.
Individual
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)4139 CADILLAC CT SUITE 201
LOUISVILLE, KY 40213
(502) 425-0500
1093704082DR. GABOR G NEMETH M.D.
Individual
Ophthalmology4139 CADILLAC CT SUITE 200
LOUISVILLE, KY 40213
(502) 473-4835

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.