Healthcare Provider Details

I. General information

NPI: 1861385296
Provider Name (Legal Business Name): PLATINUM HOME & COMMUNITY MOBILITY CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2025
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

748 24 MILE RD
HOMER MI
49245-9636
US

IV. Provider business mailing address

15400 PEARL RD STE 207
STRONGSVILLE OH
44136-6051
US

V. Phone/Fax

Practice location:
  • Phone: 440-229-5822
  • Fax: 904-261-1164
Mailing address:
  • Phone: 440-229-5822
  • Fax: 440-448-4902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MARC ANTHONY VASIL
Title or Position: PRESIDENT
Credential: MPT
Phone: 440-229-5822