Provider Demographics
NPI:1376186825
Name:VAND V HEALTHCARE SERVICE
Entity Type:Organization
Organization Name:VAND V HEALTHCARE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:D
Authorized Official - Last Name:BUCKLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-580-6739
Mailing Address - Street 1:P.O. BOX 7451
Mailing Address - Street 2:7451
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-7451
Mailing Address - Country:US
Mailing Address - Phone:516-580-6739
Mailing Address - Fax:516-280-8606
Practice Address - Street 1:132 WEST MERRICK ROAD
Practice Address - Street 2:BX 7451
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-7451
Practice Address - Country:US
Practice Address - Phone:516-580-6739
Practice Address - Fax:516-280-8606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-28
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251J00000XAgenciesNursing Care
No251K00000XAgenciesPublic Health or Welfare
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No251X00000XAgenciesSupports Brokerage
No253Z00000XAgenciesIn Home Supportive Care