Healthcare Provider Details

I. General information

NPI: 1780262097
Provider Name (Legal Business Name): VASCO HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2021
Last Update Date: 03/30/2021
Certification Date: 03/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5520 E MAIN ST STE 3
MESA AZ
85205-8793
US

IV. Provider business mailing address

4045 E BELL RD STE 157
PHOENIX AZ
85032-2240
US

V. Phone/Fax

Practice location:
  • Phone: 602-346-0204
  • Fax:
Mailing address:
  • Phone: 602-404-0015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PAUL VASILIAUSKAS
Title or Position: SR VP BUSINESS DEVELOPMENT
Credential:
Phone: 602-971-6950