Provider Demographics
NPI:1548009616
Name:CROWN POINT VC1, LLC
Entity type:Organization
Organization Name:CROWN POINT VC1, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:P
Authorized Official - Last Name:MORANDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-295-4080
Mailing Address - Street 1:1290 ARROWHEAD CT STE A
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-7766
Mailing Address - Country:US
Mailing Address - Phone:219-295-4080
Mailing Address - Fax:219-600-1800
Practice Address - Street 1:1290 ARROWHEAD CT STE A
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-7766
Practice Address - Country:US
Practice Address - Phone:219-295-4080
Practice Address - Fax:219-600-1800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-20
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No251F00000XAgenciesHome Infusion
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No3336C0004XSuppliersPharmacyCompounding Pharmacy