Healthcare Provider Details

I. General information

NPI: 1538817291
Provider Name (Legal Business Name): VJ HEALTH CARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2022
Last Update Date: 03/12/2022
Certification Date: 03/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 E MAIN ST
AYER MA
01432-1608
US

IV. Provider business mailing address

34 E MAIN ST
AYER MA
01432-1608
US

V. Phone/Fax

Practice location:
  • Phone: 347-845-2425
  • Fax:
Mailing address:
  • Phone: 347-845-2425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: FREDRICK OMODIAGBE
Title or Position: FOUNDER
Credential:
Phone: 347-845-2425