MEDICARE: VIEMED CLINICAL SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	171M00000X	Case Manager/Care Coordinator
2	253Z00000X	In Home Supportive Care Agency
3	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1528648227
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIEMED CLINICAL SERVICES, LLC

Provider Business Mailing Address
First Line	:	9726 E 42ND ST STE 135
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74146-3626
Country	:	US
Telephone Number	:	833-452-0220
Fax Number	:	800-398-9547

Provider Business Practice Location Address
First Line	:	9726 E 42ND ST STE 135
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74146-3626
Country	:	US
Telephone Number	:	833-452-0220
Fax Number	:	800-398-9547

Authorized Official
Title or Position	:	EXECUTIVE VP
Name	:	RYAN SULLIVAN
Credential	:
Telephone Number	:	337-504-3802

Provider Enumeration Date	:	04/08/2021
Last Update Date	:	04/08/2021

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