# VINTAGE HEALTHCARE SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649188897
- **Authorized official:** EDRICK BAHAM (ADMINISTRATOR)
- **Authorized official phone:** (214) 217-0574

## Contact information

- **Practice address:** 1341 W MOCKINGBIRD LN STE 500W, DALLAS, TX 75247-6903
- **Practice address phone:** (214) 217-0574
- **Practice address fax:** (214) 217-0611
- **Mailing address:** 1341 W MOCKINGBIRD LN STE 500W, DALLAS, TX 75247-6903
- **Mailing address phone:** (214) 217-0574
- **Mailing address fax:** (214) 217-0611

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 08/31/2026
- **Last updated:** 08/31/2026