Healthcare Provider Details

I. General information

NPI: 1770135758
Provider Name (Legal Business Name): VAS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2019
Last Update Date: 07/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 N ROYAL AVE
EVANSVILLE IN
47715-7843
US

IV. Provider business mailing address

1221 N ROYAL AVE
EVANSVILLE IN
47715-7843
US

V. Phone/Fax

Practice location:
  • Phone: 812-475-9199
  • Fax: 888-221-4542
Mailing address:
  • Phone: 812-475-9199
  • Fax: 888-221-4542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: VIRGINIA A STEINER
Title or Position: TIN OWNER
Credential: FNP
Phone: 618-889-8101