Provider Demographics
| NPI: | 1871757625 |
|---|---|
| Name: | VIACELL INT'L LLC |
| Entity type: | Organization |
| Organization Name: | VIACELL INT'L LLC |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CEO |
| Authorized Official - Prefix: | MR |
| Authorized Official - First Name: | LINDEN |
| Authorized Official - Middle Name: | BARRINGTON |
| Authorized Official - Last Name: | EDMONDSON |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 832-754-7820 |
| Mailing Address - Street 1: | 4263 HAMBLEDON VILLAGE DR |
| Mailing Address - Street 2: | |
| Mailing Address - City: | HOUSTON |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 77014-1844 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 832-754-7820 |
| Mailing Address - Fax: | 281-587-9484 |
| Practice Address - Street 1: | 4263 HAMBLEDON VILLAGE DR |
| Practice Address - Street 2: | |
| Practice Address - City: | HOUSTON |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 77014-1844 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 832-754-7820 |
| Practice Address - Fax: | 281-587-9484 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2008-07-10 |
| Last Update Date: | 2008-07-10 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| TX | 746549 | 311Z00000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 311Z00000X | Nursing & Custodial Care Facilities | Custodial Care Facility |