| Organization Name: | PRO-VAC, INC |
| NPI Number: | 1043498439 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JUDITH CARLETTA (VICE PRESIDANT/OPTICIAN) |
| Mailing Address: | 2315 Bridge Ave Point Pleasant Boro |
| State: | NJ US |
| Postal Code: | 087424329 |
| Phone Number: | 7328927717 |
| Fax Number: | 7328927836 |
| NPI Enumeration Date: | 02/07/2008 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | 31TD00300700 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |