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General NPI Number Information
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NPI Number | 1891708699
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Entity Type | Organization
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Legal Business Name | VEGA HEALTHCARE INC.
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 408 JACKSON AVE E
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City | HAMPTON
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State | SC
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Zip | 29924-3602
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Country | US
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Telephone | 803-943-3813
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Fax | 803-943-5971
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Provider Business Mailing Address
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Address Line | 408 JACKSON AVE E
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City | HAMPTON
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State | SC
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Zip | 29924-3602
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Country | US
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Telephone | 803-943-3813
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Fax | 803-943-5971
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. SHARON R RYAN
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Credential |
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Telephone | 803-943-3813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 23033
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 28595
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License Number State | SC
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