Provider Demographics
NPI:1396868998
Name:VASCULAR CARE INTERNATIONAL, INC.
Entity type:Organization
Organization Name:VASCULAR CARE INTERNATIONAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CASSANDRE
Authorized Official - Middle Name:J
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-642-4100
Mailing Address - Street 1:12966 COUNTY ROAD 153
Mailing Address - Street 2:
Mailing Address - City:EAST LIBERTY
Mailing Address - State:OH
Mailing Address - Zip Code:43319-9431
Mailing Address - Country:US
Mailing Address - Phone:937-642-4100
Mailing Address - Fax:937-642-4104
Practice Address - Street 1:12966 COUNTY ROAD 153
Practice Address - Street 2:
Practice Address - City:EAST LIBERTY
Practice Address - State:OH
Practice Address - Zip Code:43319-9431
Practice Address - Country:US
Practice Address - Phone:937-642-4100
Practice Address - Fax:937-642-4104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0553579000OtherKEYSTONE
244562OtherKAISER PERMANENTE
117263OtherAMERICAID
294349OtherAMERIGROUP
5319603OtherAETNA HEALTHCARE
76379MDIOtherMDIPA
A1309454OtherOXFORD HEALTHCARE
703985OtherHARVARD PILGRIM
000000375906OtherBCBS
N46792OtherHEALTHNET PHS
A1309454OtherOXFORD HEALTHCARE