Provider Demographics
NPI:1023206828
Name:VAP PROFESSIONALS LLC
Entity Type:Organization
Organization Name:VAP PROFESSIONALS LLC
Other - Org Name:BRAND ORTHOPEDICS AND SHOE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:POMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-864-5608
Mailing Address - Street 1:21701 W 11 MILE RD STE 2
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-3713
Mailing Address - Country:US
Mailing Address - Phone:248-352-0000
Mailing Address - Fax:248-352-0001
Practice Address - Street 1:21701 W 11 MILE RD
Practice Address - Street 2:SUITE 2
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-3713
Practice Address - Country:US
Practice Address - Phone:248-352-0000
Practice Address - Fax:248-352-0001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-07
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4495766Medicaid
MICO2874OtherABC
MI4059900001Medicare NSC