Provider Demographics
NPI:1053937268
Name:VGM GROUP, INC.
Entity type:Organization
Organization Name:VGM GROUP, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP, COMPLIANCE & ACCREDITATION
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HARBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-875-6140
Mailing Address - Street 1:1111 VAN MILLER WAY
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50701-1118
Mailing Address - Country:US
Mailing Address - Phone:319-243-5475
Mailing Address - Fax:
Practice Address - Street 1:1111 VAN MILLER WAY
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50701-1118
Practice Address - Country:US
Practice Address - Phone:319-243-5475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VGM GROUP, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-23
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No251F00000XAgenciesHome Infusion