Provider Demographics
NPI:1679015986
Name:VESRETTA HOMECARE & SUPPLIES INC.
Entity Type:Organization
Organization Name:VESRETTA HOMECARE & SUPPLIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-465-5151
Mailing Address - Street 1:19913 MURDOCK AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:NY
Mailing Address - Zip Code:11412-2510
Mailing Address - Country:US
Mailing Address - Phone:718-465-5151
Mailing Address - Fax:
Practice Address - Street 1:19913 MURDOCK AVE
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:NY
Practice Address - Zip Code:11412-2510
Practice Address - Country:US
Practice Address - Phone:718-465-5151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-17
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies