Provider Demographics
NPI:1104332147
Name:VASCULAR IMAGING SOLUTIONS LLC
Entity type:Organization
Organization Name:VASCULAR IMAGING SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HAGEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RVT
Authorized Official - Phone:602-614-5253
Mailing Address - Street 1:13920 W CAMINO DEL SOL
Mailing Address - Street 2:SUITE 7
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375-4438
Mailing Address - Country:US
Mailing Address - Phone:602-614-5253
Mailing Address - Fax:602-428-6860
Practice Address - Street 1:12425 W BELL RD
Practice Address - Street 2:STE A-128
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85378-9002
Practice Address - Country:US
Practice Address - Phone:602-614-5253
Practice Address - Fax:602-428-6860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-27
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty