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General NPI Number Information
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NPI Number | 1245313246
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Entity Type | Organization
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Legal Business Name | VARGO ENTERPRISES INC
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 09/26/2008
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Provider Practice Location Address
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Address Line | 2017 SOUTH MAIN
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City | PARIS
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State | KY
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Zip | 40361
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Country | US
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Telephone | 859-987-1665
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Fax | 859-987-3064
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Provider Business Mailing Address
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Address Line | 2017 SOUTH MAIN
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City | PARIS
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State | KY
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Zip | 40361
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Country | US
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Telephone | 859-987-1665
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Fax | 859-987-3064
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Authorized Official
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Title or Position | LAB MANAGER
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Name | MS. HENRIETTA RUTH GREY
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Credential | CLS
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Telephone | 859-987-1665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 200122
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 896
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License Number State | KY
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