Provider Demographics
NPI:1780769224
Name:VEIN & COSMETIC SOLUTIONS
Entity type:Organization
Organization Name:VEIN & COSMETIC SOLUTIONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:H
Authorized Official - Last Name:WIDMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:434-847-5347
Mailing Address - Street 1:7626 TIMBERLAKE RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-2325
Mailing Address - Country:US
Mailing Address - Phone:434-847-5347
Mailing Address - Fax:434-316-7008
Practice Address - Street 1:7626 TIMBERLAKE RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-2325
Practice Address - Country:US
Practice Address - Phone:434-847-5347
Practice Address - Fax:434-316-7008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261Q00000X
VA0101049993174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7187888OtherAETNA
VADD5891OtherRAILROAD MEDICARE
VA176753OtherANTHEM
VA429868OtherSOUTHERN HEALTH
VA176753OtherANTHEM