Provider Demographics
NPI:1831225176
Name:VKL COMPANY
Entity type:Organization
Organization Name:VKL COMPANY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VLADIMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:MALINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-226-0140
Mailing Address - Street 1:9998 SWANSON BLVD
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-6903
Mailing Address - Country:US
Mailing Address - Phone:515-226-0140
Mailing Address - Fax:515-334-0037
Practice Address - Street 1:9998 SWANSON BLVD
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-6903
Practice Address - Country:US
Practice Address - Phone:515-226-0140
Practice Address - Fax:515-334-0037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0068254Medicaid