Center For Vein Restoration MD LLC
in Hagerstown, MD. Organization (NPI-2).
NPI number1023830320
StatusActive
Last updated in NPPESOct 28, 2024
Details
- NPI
- 1023830320
- Entity type
- Organization (NPI-2)
- Legal business name
- Center For Vein Restoration MD LLC
- Organization subpart
- No
- Enumeration date
- Oct 28, 2024
- Certification date
- Oct 28, 2024
- Last updated
- Oct 28, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2086S0129X | – | – | Yes |
Practice location
1401 Dual HwyHagerstown, MD 21740-6568
Phone 855-830-8346 · Fax 240-473-4321
Mailing address
7474 Greenway Center Dr Ste 1000Greenbelt, MD 20770-3500
Phone 815-254-1761 · Fax 240-473-4321
Authorized official
Lorena Thomas
Credentialing Manager
8152541761
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