Provider Demographics
NPI:1598893059
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:PRESIDENT
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 100
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-8349
Mailing Address - Country:US
Mailing Address - Phone:803-909-3600
Mailing Address - Fax:
Practice Address - Street 1:12610 N COMMUNITY HOUSE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-3891
Practice Address - Country:US
Practice Address - Phone:704-405-1747
Practice Address - Fax:803-909-3800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT84209Medicaid
SCH96293Medicare UPIN