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General NPI Number Information
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NPI Number | 1588274401
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Entity Type | Organization
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Legal Business Name | VIP MEDICAL CARE
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Dates
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Enumeration Date | 08/05/2020
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Last Update Date | 08/05/2020
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Provider Practice Location Address
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Address Line | 18940 SCHOOLCRAFT
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City | DETROIT
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State | MI
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Zip | 48223-2906
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Country | US
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Telephone | 313-332-0360
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Fax |
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Provider Business Mailing Address
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Address Line | 18940 SCHOOLCRAFT
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City | DETROIT
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State | MI
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Zip | 48223-2906
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Country | US
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Telephone | 313-332-0360
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LASHAUNDRA COX
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Credential |
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Telephone | 313-208-1635
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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