Healthcare Provider Details

I. General information

NPI: 1285566695
Provider Name (Legal Business Name): TAI HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9412 BIG HORN BLVD STE 5
ELK GROVE CA
95758-1101
US

IV. Provider business mailing address

2411 8TH AVE
SACRAMENTO CA
95818-4448
US

V. Phone/Fax

Practice location:
  • Phone: 209-918-1450
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DAVID VERMEULEN
Title or Position: PRESIDENT
Credential:
Phone: 209-918-1450