Provider Demographics
NPI:1205256989
Name:AIKEN VEIN
Entity type:Organization
Organization Name:AIKEN VEIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTHCARE PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:WEEMS
Authorized Official - Middle Name:R
Authorized Official - Last Name:PENNINGTON
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:706-840-5277
Mailing Address - Street 1:137 MIRACLE DR
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-6351
Mailing Address - Country:US
Mailing Address - Phone:803-641-4874
Mailing Address - Fax:803-641-1669
Practice Address - Street 1:137 MIRACLE DR
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-6351
Practice Address - Country:US
Practice Address - Phone:803-641-4874
Practice Address - Fax:803-641-1669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-22
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22253261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical