Provider Demographics
NPI:1992823322
Name:AIR VAC INC
Entity Type:Organization
Organization Name:AIR VAC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:LOUCAS
Authorized Official - Last Name:VACRACOS
Authorized Official - Suffix:
Authorized Official - Credentials:PAC
Authorized Official - Phone:219-923-0927
Mailing Address - Street 1:2909 JEWETT AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:46322-1776
Mailing Address - Country:US
Mailing Address - Phone:219-838-5059
Mailing Address - Fax:219-838-5059
Practice Address - Street 1:2909 JEWETT AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322-1776
Practice Address - Country:US
Practice Address - Phone:219-838-5059
Practice Address - Fax:219-838-5059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
IL2278H0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No2278H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedHome HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN5582400001OtherDMERC NUMBER
IN5582400001OtherDMERC NUMBER
IN5582400001Medicare NSC