Provider Demographics
NPI:1790933117
Name:SPECS HEALTHCARE, INC.
Entity Type:Organization
Organization Name:SPECS HEALTHCARE, INC.
Other - Org Name:AVIA MOBILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:VOGELSANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-342-1234
Mailing Address - Street 1:690 CORDOVAN DR
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-6000
Mailing Address - Country:US
Mailing Address - Phone:916-234-3124
Mailing Address - Fax:
Practice Address - Street 1:690 CORDOVAN DR
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-6000
Practice Address - Country:US
Practice Address - Phone:916-234-3124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-28
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No251V00000XAgenciesVoluntary or Charitable
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
0513060002OtherNPES
0513060001OtherNPES
CADME00865F7Medicaid