Provider Demographics
NPI:1497729560
Name:VASCULAR ENHANCEMENT CENTERS L.L.C.
Entity Type:Organization
Organization Name:VASCULAR ENHANCEMENT CENTERS L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:ROCKEFELLER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:918-836-9100
Mailing Address - Street 1:8523 E 11TH ST
Mailing Address - Street 2:STE. A
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74112-7963
Mailing Address - Country:US
Mailing Address - Phone:918-836-9100
Mailing Address - Fax:918-836-9106
Practice Address - Street 1:8523 E 11TH ST
Practice Address - Street 2:STE. A
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74112-7963
Practice Address - Country:US
Practice Address - Phone:918-836-9100
Practice Address - Fax:918-836-9106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK374511Medicare ID - Type Unspecified