Organization Active NPI

Vintage Healthcare Services LLC

  • Durable Medical Equipment & Medical Supplies
  • Dallas, TX
National Provider Identifier
1649188897
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
VINTAGE HEALTHCARE SERVICES LLC
Practice address
1341 W Mockingbird LN Ste 500W
Dallas, TX 75247-6903
Phone
(214) 217-0574
Fax
(214) 217-0611
NPI assigned
Aug 31, 2026
Last updated
Aug 31, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Authorized official

Name
Edrick Baham
Title
Administrator
Phone
(214) 217-0574

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

1341 W Mockingbird LN Ste 500W
Dallas, TX 75247-6903

Mailing address

1341 W Mockingbird LN Ste 500W
Dallas, TX 75247-6903
Phone (214) 217-0574

National Provider Directory

National Provider Directory
Tax ID family
Vintage Healthcare Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1788134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788134400000",
    "number": "1649188897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1341 W MOCKINGBIRD LN STE 500W",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752476903",
            "telephone_number": "214-217-0574",
            "fax_number": "214-217-0611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1341 W MOCKINGBIRD LN STE 500W",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752476903",
            "telephone_number": "214-217-0574",
            "fax_number": "214-217-0611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINTAGE HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-31",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-30",
        "status": "A",
        "authorized_official_last_name": "BAHAM",
        "authorized_official_first_name": "EDRICK",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "214-217-0574"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.