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General NPI Number Information
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NPI Number | 1114951100
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Entity Type | Organization
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Legal Business Name | VICLEN, INC.
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 11/02/2015
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Provider Practice Location Address
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Address Line | 1794 BRYAN STATION RD
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City | LEXINGTON
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State | KY
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Zip | 40505-2133
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Country | US
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Telephone | 859-253-6611
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Fax | 859-514-3506
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Provider Business Mailing Address
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Address Line | 101 VENTURE CT
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City | LEXINGTON
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State | KY
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Zip | 40511-2615
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Country | US
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Telephone | 859-253-6611
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Fax | 859-259-2346
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. VICKI S. HOUSE
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Credential |
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Telephone | 859-253-6611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | MG0305
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License Number State | KY
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