Healthcare Provider Details

I. General information

NPI: 1407779770
Provider Name (Legal Business Name): LRA VASCULAR SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 S EASTOWN RD
LIMA OH
45805
US

IV. Provider business mailing address

730 W MARKET ST
LIMA OH
45801-4602
US

V. Phone/Fax

Practice location:
  • Phone: 419-226-4382
  • Fax:
Mailing address:
  • Phone: 419-226-4382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: LAURA SCHNIPKE
Title or Position: PRACTICE MANAGER
Credential:
Phone: 419-230-9792