Provider Demographics
NPI:1811021892
Name:VEIN CARE OF THE VIRGINIAS PLLC
Entity Type:Organization
Organization Name:VEIN CARE OF THE VIRGINIAS PLLC
Other - Org Name:VEIN CARE OF THE VIRGINIAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:GRAYBEAL
Authorized Official - Last Name:KEATING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-254-8346
Mailing Address - Street 1:921 WEST NEVILLE ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-4360
Mailing Address - Country:US
Mailing Address - Phone:304-254-8346
Mailing Address - Fax:
Practice Address - Street 1:921 W NEVILLE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-4360
Practice Address - Country:US
Practice Address - Phone:304-254-8346
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20972261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty