Provider Demographics
NPI:1760422554
Name:VCM HEALTHCARE LLC
Entity Type:Organization
Organization Name:VCM HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EMILIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MBANWITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-636-4483
Mailing Address - Street 1:12200 FORD RD STE A200
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7244
Mailing Address - Country:US
Mailing Address - Phone:214-592-1441
Mailing Address - Fax:214-367-4311
Practice Address - Street 1:13601 PRESTON RD STE 548W
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-5293
Practice Address - Country:US
Practice Address - Phone:214-592-1441
Practice Address - Fax:214-367-4311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010556251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679616Medicare Oscar/Certification