Provider Demographics
NPI:1760755862
Name:VEZCO
Entity Type:Organization
Organization Name:VEZCO
Other - Org Name:OVAL MED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AYANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-773-1771
Mailing Address - Street 1:PO BOX 5524
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23471-0524
Mailing Address - Country:US
Mailing Address - Phone:800-634-1772
Mailing Address - Fax:800-634-1775
Practice Address - Street 1:522 S INDEPENDENCE BLVD STE 104
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1149
Practice Address - Country:US
Practice Address - Phone:800-634-1772
Practice Address - Fax:800-634-1775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-21
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies