Provider Demographics
NPI:1376821470
Name:VITALCARE HOME MEDICAL EQUIPMENT
Entity type:Organization
Organization Name:VITALCARE HOME MEDICAL EQUIPMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-627-2031
Mailing Address - Street 1:761 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:CHEBOYGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49721-2117
Mailing Address - Country:US
Mailing Address - Phone:231-627-7157
Mailing Address - Fax:231-597-8202
Practice Address - Street 1:994 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CHEBOYGAN
Practice Address - State:MI
Practice Address - Zip Code:49721-2265
Practice Address - Country:US
Practice Address - Phone:231-627-7157
Practice Address - Fax:231-597-8202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-25
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies