- Enrollment id
- O20141009002690
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1881909299
- Multiple npi flag
- N
- Ccn
- 747948
- Associate id
- 1759515166
- Organization name
- VIKA MEDICAL SERVICES LLC
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 10300 NORTH CENTRAL EXPRESSWAY
- Address line 2
- SUITE 190
- City
- DALLAS
- State
- TX
- Zip code
- 752318600