Provider Demographics
NPI:1871075580
Name:VENDOR PRO HEALTHCARE SERVICES
Entity type:Organization
Organization Name:VENDOR PRO HEALTHCARE SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:DOYLE
Authorized Official - Last Name:BOHANNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-219-1922
Mailing Address - Street 1:42 BOW PERCH LN STE 4
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-9362
Mailing Address - Country:US
Mailing Address - Phone:406-219-1933
Mailing Address - Fax:406-219-1933
Practice Address - Street 1:42 BOW PERCH LN STE 4
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-9362
Practice Address - Country:US
Practice Address - Phone:406-219-1933
Practice Address - Fax:406-219-1933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies