Vida Medical Supplies LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

VIDA MEDICAL SUPPLIES LLC

Practice address

1002 N Avasolo St
Rio Grande City, TX 78582-2811

Phone

(956) 488-0108

Fax

(956) 488-0525

NPI assigned

May 27, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Juan D Garcia

Title

Owner / President

Phone

(956) 488-0108

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488931200000",
    "number": "1619924628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 N AVASOLO ST",
            "city": "RIO GRANDE CITY",
            "state": "TX",
            "postal_code": "785822811",
            "telephone_number": "956-488-0108",
            "fax_number": "956-488-0525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 N AVASOLO ST",
            "city": "RIO GRANDE CITY",
            "state": "TX",
            "postal_code": "785822811",
            "telephone_number": "956-488-0108",
            "fax_number": "956-488-0525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIDA MEDICAL SUPPLIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2017-03-08",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER / PRESIDENT",
        "authorized_official_telephone_number": "956-488-0108"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175420202",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID CCP SUFFIX 01",
            "identifier": "175420201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julia Edith Vazquez, FNP
• Lysandra Vela, FNP-C
• Jessica Vera-Rios, CRC, LPC
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• Vida Bendita Adult Day Care, LLC
• Villa Dorada Day Center, Inc.
• Rina Renee Villanueva, LPC-ASSOCIATE
• Brandy Villarreal, LMSW
• Carolyn Villarreal, COTA
• Elizabeth Denise Villarreal, CCC-SLP

• Durable Medical Equipment & Medical Supplies in Rio Grande City, TX
• Providers in Rio Grande City, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.