Provider Demographics
NPI:1811040223
Name:VASCULAR PROFESSIONALS, INC.
Entity Type:Organization
Organization Name:VASCULAR PROFESSIONALS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:LOU
Authorized Official - Last Name:HAHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-251-2411
Mailing Address - Street 1:2213 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43608-2603
Mailing Address - Country:US
Mailing Address - Phone:419-251-3112
Mailing Address - Fax:419-251-3712
Practice Address - Street 1:2213 CHERRY ST
Practice Address - Street 2:SUITE 303 ACC
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43608-2603
Practice Address - Country:US
Practice Address - Phone:419-251-3112
Practice Address - Fax:419-251-3712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0450846Medicaid
GACB7019Medicare PIN
MI0N98710Medicare PIN
OH0450846Medicaid