Healthcare Provider Details

I. General information

NPI: 1861498347
Provider Name (Legal Business Name): VIP HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 08/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 06 MYRTLE AVE
RICHMOND HILL NY
11418-1748
US

IV. Provider business mailing address

116-06 MYRTLE AVE
RICHMOND HILL NY
11418-1748
US

V. Phone/Fax

Practice location:
  • Phone: 718-847-5100
  • Fax: 718-849-5422
Mailing address:
  • Phone: 718-847-5100
  • Fax: 718-849-5422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number7003609
License Number StateNY

VIII. Authorized Official

Name: MR. GARY S BROWN
Title or Position: DIRECTOR
Credential:
Phone: 718-847-5100