Healthcare Provider Details

I. General information

NPI: 1134183791
Provider Name (Legal Business Name): VI PATHOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 04/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4093 DIAMOND RUBY SUITE 7
CHRISTIANSTED VI
00820-4424
US

IV. Provider business mailing address

PO BOX 49009
GREENWOOD SC
29649-0001
US

V. Phone/Fax

Practice location:
  • Phone: 340-778-6311
  • Fax:
Mailing address:
  • Phone: 864-223-3070
  • Fax: 864-223-1396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number1231
License Number StateVI

VIII. Authorized Official

Name: JAMES KASIN
Title or Position: PRESIDENT
Credential: MD
Phone: 340-778-6311