Provider Demographics
NPI:1558813444
Name:VINE MEDICAL EQUIPMENT, LLC
Entity Type:Organization
Organization Name:VINE MEDICAL EQUIPMENT, LLC
Other - Org Name:VINE MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:VELA
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:956-739-8086
Mailing Address - Street 1:1100 NW LOOP 410
Mailing Address - Street 2:SUITE 730
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-2263
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1100 NW LOOP 410
Practice Address - Street 2:SUITE 730
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213-2263
Practice Address - Country:US
Practice Address - Phone:210-366-0366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-26
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies