Provider Demographics
NPI:1275930927
Name:COLUMBUS VASCULAR VEIN AND WOUND CENTER LLC
Entity Type:Organization
Organization Name:COLUMBUS VASCULAR VEIN AND WOUND CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RAJMONY
Authorized Official - Middle Name:
Authorized Official - Last Name:PANNU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-800-1995
Mailing Address - Street 1:450 ALKYRE RUN DRIVE
Mailing Address - Street 2:350
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-6909
Mailing Address - Country:US
Mailing Address - Phone:614-800-1995
Mailing Address - Fax:
Practice Address - Street 1:450 ALKYRE RUN DRIVE
Practice Address - Street 2:350
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-6909
Practice Address - Country:US
Practice Address - Phone:614-917-0696
Practice Address - Fax:888-732-7890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-24
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center