MEDICARE: VIP HEALTH CARE SERVICES INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	1493L004	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093712564
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIP HEALTH CARE SERVICES INC.

Provider Business Mailing Address
First Line	:	11612 MYRTLE AVE
Second Line	:
City	:	RICHMOND HILL
State	:	NY
Zip	:	11418-1748
Country	:	US
Telephone Number	:	718-847-9800
Fax Number	:	718-847-9652

Provider Business Practice Location Address
First Line	:	492 JERUSALEM AVE
Second Line	:
City	:	UNIONDALE
State	:	NY
Zip	:	11553-2512
Country	:	US
Telephone Number	:	516-292-9300
Fax Number	:	516-292-9072

Authorized Official
Title or Position	:	CONTROLLER
Name	:	MRS. ZIPORAH WILON
Credential	:
Telephone Number	:	718-847-9800

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	08/22/2007

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Directions to “VIP HEALTH CARE SERVICES INC. ” Practice Location

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