Provider Demographics
NPI:1609208149
Name:MEDIC EAST CORP
Entity Type:Organization
Organization Name:MEDIC EAST CORP
Other - Org Name:SENIORCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VATCH
Authorized Official - Suffix:
Authorized Official - Credentials:MPA, LNHA, CCEMT-P
Authorized Official - Phone:718-430-9700
Mailing Address - Street 1:700 HAVEMEYER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-1102
Mailing Address - Country:US
Mailing Address - Phone:718-430-9700
Mailing Address - Fax:718-430-1528
Practice Address - Street 1:700 HAVEMEYER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-1102
Practice Address - Country:US
Practice Address - Phone:718-430-9700
Practice Address - Fax:718-430-1528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-07
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport