Provider Demographics
NPI:1235310699
Name:VISIONQUEST INDUSTRIES, INC.
Entity Type:Organization
Organization Name:VISIONQUEST INDUSTRIES, INC.
Other - Org Name:VQ ORTHOCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ROY
Authorized Official - Last Name:HUFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-794-3440
Mailing Address - Street 1:1390 DECISION ST STE A
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081-8578
Mailing Address - Country:US
Mailing Address - Phone:800-266-6969
Mailing Address - Fax:888-266-6968
Practice Address - Street 1:1390 DECISION ST STE A
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-8578
Practice Address - Country:US
Practice Address - Phone:949-261-3000
Practice Address - Fax:888-266-6968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101923332B00000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000158087Medicaid
NM24886858Medicaid
SCDM1594Medicaid
NE10026689800Medicaid
IN200100380AMedicaid
TN1455031Medicaid
SCDE2706Medicaid
CA0676960001Medicare NSC