MEDICARE: VAUGHT INFUSION SERVICES, PLLC

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	2084N0400X	Neurology Physician

General Provider Information

NPI Number	:	1326884057
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VAUGHT INFUSION SERVICES, PLLC

Provider Business Mailing Address
First Line	:	1404 ROBERT C BYRD DR STE 202
Second Line	:
City	:	CRAB ORCHARD
State	:	WV
Zip	:	25827-9470
Country	:	US
Telephone Number	:	304-252-2222
Fax Number	:

Provider Business Practice Location Address
First Line	:	1404 ROBERT C BYRD DR STE 202
Second Line	:
City	:	CRAB ORCHARD
State	:	WV
Zip	:	25827-9470
Country	:	US
Telephone Number	:	304-252-4222
Fax Number	:

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	AMY O'NEAL
Credential	:
Telephone Number	:	304-252-4222

Provider Enumeration Date	:	07/02/2024
Last Update Date	:	10/15/2024

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