Healthcare Provider Details

I. General information

NPI: 1932737863
Provider Name (Legal Business Name): VAS DYNAMICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2020
Last Update Date: 01/31/2026
Certification Date: 01/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12911 INDUSTRIAL PARK DR UNIT 3
GRANGER IN
46530-4604
US

IV. Provider business mailing address

10609 BREMS CT
OSCEOLA IN
46561-9097
US

V. Phone/Fax

Practice location:
  • Phone: 574-622-8500
  • Fax: 574-575-4388
Mailing address:
  • Phone: 574-340-5941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY SMALLWOOD
Title or Position: MEMBER
Credential:
Phone: 574-340-5941