Provider Demographics
NPI:1598099137
Name:VITALCARE HOME MEDICAL EQUIPMENT INC
Entity Type:Organization
Organization Name:VITALCARE HOME MEDICAL EQUIPMENT INC
Other - Org Name:MCLAREN HOME MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-627-2031
Mailing Address - Street 1:761 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:CHEBOYGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49721
Mailing Address - Country:US
Mailing Address - Phone:231-627-2031
Mailing Address - Fax:231-268-3692
Practice Address - Street 1:602 W. SEYMOUR STREET
Practice Address - Street 2:
Practice Address - City:CHEBOYGAN
Practice Address - State:MI
Practice Address - Zip Code:49721
Practice Address - Country:US
Practice Address - Phone:231-627-2031
Practice Address - Fax:231-268-3692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-30
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIHME-0150738332BX2000X
MI332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
56737OtherNORTHWOOD NPN
540F90342OtherBC/BS
MI0504550004Medicare NSC