Provider Demographics
NPI:1174926620
Name:VICKERS CORP.
Entity type:Organization
Organization Name:VICKERS CORP.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:NATALEE
Authorized Official - Middle Name:GEANNETTE
Authorized Official - Last Name:VICKERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-514-6767
Mailing Address - Street 1:12110 ELIJAH STAPP
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-5096
Mailing Address - Country:US
Mailing Address - Phone:210-514-6767
Mailing Address - Fax:
Practice Address - Street 1:9258 CULEBRA RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-2871
Practice Address - Country:US
Practice Address - Phone:210-514-6767
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-29
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care