Provider Demographics
NPI:1639443013
Name:V.I.P HEALTHCARE, LLC
Entity Type:Organization
Organization Name:V.I.P HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:BELYNDA
Authorized Official - Last Name:DORCENA
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:617-872-9081
Mailing Address - Street 1:500 N MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-6700
Mailing Address - Country:US
Mailing Address - Phone:617-872-9081
Mailing Address - Fax:
Practice Address - Street 1:500 N MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-6700
Practice Address - Country:US
Practice Address - Phone:617-872-9081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-01
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7483302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization