Organization
VENCER CARE, LLC
Active
Other names
Vencer Vital Care
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN BAHRI (PRESIDENT)
(201) 881-0773
Entity
Organization
Contact information
Practice address
255 W SPRING VALLEY AVE STE 201, MAYWOOD, NJ 07607-1444
(888) 554-9554
(201) 881-0776
Mailing address
255 W SPRING VALLEY AVE STE 201, MAYWOOD, NJ 07607-1444
(888) 554-9554
(201) 881-0776
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
28RS00734800
NY
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
28RS00734800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0463621
—
NJ
Enumeration date
12/08/2017
Last updated
12/08/2017
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