Provider Demographics
NPI:1023639192
Name:VINCENT HOLDINGS LLC
Entity type:Organization
Organization Name:VINCENT HOLDINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JARED
Authorized Official - Middle Name:B
Authorized Official - Last Name:JUNGINA VINCENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-598-1411
Mailing Address - Street 1:PO BOX 2731
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78691-2731
Mailing Address - Country:US
Mailing Address - Phone:512-598-1411
Mailing Address - Fax:
Practice Address - Street 1:16845 TORTOISE ST
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-8604
Practice Address - Country:US
Practice Address - Phone:512-598-1411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-30
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies