Provider Demographics
NPI:1013534163
Name:VIMAX LLC
Entity Type:Organization
Organization Name:VIMAX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VIKTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:DUBINSKIY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-616-8090
Mailing Address - Street 1:108 GALLOPING HILL RD
Mailing Address - Street 2:
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722-1538
Mailing Address - Country:US
Mailing Address - Phone:732-616-8090
Mailing Address - Fax:
Practice Address - Street 1:1749 HOOPER AVE STE 202
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-8130
Practice Address - Country:US
Practice Address - Phone:732-930-1020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-05
Last Update Date:2020-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder