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General NPI Number Information
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NPI Number | 1518996644
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Entity Type | Organization
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Legal Business Name | VASCULAR ACCESS CENTER OF PRINCE GEORGES COUNTY LLC
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 06/27/2013
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Provider Practice Location Address
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Address Line | 1019 BRIGHTSEAT RD
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City | LANDOVER
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State | MD
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Zip | 20785-3738
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Country | US
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Telephone | 301-350-6009
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Fax |
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Provider Business Mailing Address
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Address Line | 1019 BRIGHTSEAT RD
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City | LANDOVER
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State | MD
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Zip | 20785-3738
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KIMBERLY J PARKINSON
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Credential |
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Telephone | 215-382-3680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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