Provider Demographics
NPI:1235369406
Name:VG&B LLC
Entity Type:Organization
Organization Name:VG&B LLC
Other - Org Name:SAVAGE FAMILY EYE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OPTICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:VANGRINSVEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-388-7192
Mailing Address - Street 1:5809 EGAN DR
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-4918
Mailing Address - Country:US
Mailing Address - Phone:612-388-7192
Mailing Address - Fax:651-455-9466
Practice Address - Street 1:5809 EGAN DR
Practice Address - Street 2:
Practice Address - City:SAVAGE
Practice Address - State:MN
Practice Address - Zip Code:55378-4918
Practice Address - Country:US
Practice Address - Phone:612-388-7192
Practice Address - Fax:651-455-9466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier