MEDICARE: THE VEIN CARE CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	17598	OH

General Provider Information

NPI Number	:	1235513367
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE VEIN CARE CENTER

Provider Business Mailing Address
First Line	:	16070 ROAD S
Second Line	:
City	:	COLUMBUS GROVE
State	:	OH
Zip	:	45830-9265
Country	:	US
Telephone Number	:	419-615-7018
Fax Number	:

Provider Business Practice Location Address
First Line	:	531 S EASTOWN RD
Second Line	:
City	:	LIMA
State	:	OH
Zip	:	45805-2800
Country	:	US
Telephone Number	:	419-227-4472
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MANU AGGARWAL
Credential	:	M.D.
Telephone Number	:	419-227-4472

Provider Enumeration Date	:	07/18/2015
Last Update Date	:	07/18/2015

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Directions to “THE VEIN CARE CENTER ” Practice Location

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