Provider Demographics
NPI:1124194196
Name:V PAIN, LLC
Entity Type:Organization
Organization Name:V PAIN, LLC
Other - Org Name:V PAIN CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RATKO
Authorized Official - Middle Name:
Authorized Official - Last Name:VUJICIC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-909-3600
Mailing Address - Street 1:410 HERLONG AVE S STE 101
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-8350
Mailing Address - Country:US
Mailing Address - Phone:803-909-3600
Mailing Address - Fax:803-909-3800
Practice Address - Street 1:410 HERLONG AVE S STE 101
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-8350
Practice Address - Country:US
Practice Address - Phone:803-909-3600
Practice Address - Fax:803-909-3800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC25109208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT84209Medicaid
SCH96293Medicare UPIN