MEDICARE: VASCO HEALTHCARE INC

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	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1780262097
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VASCO HEALTHCARE INC

Provider Business Mailing Address
First Line	:	4045 E BELL RD STE 157
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-2240
Country	:	US
Telephone Number	:	602-404-0015
Fax Number	:

Provider Business Practice Location Address
First Line	:	5520 E MAIN ST STE 3
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85205-8793
Country	:	US
Telephone Number	:	602-346-0204
Fax Number	:

Authorized Official
Title or Position	:	SR VP BUSINESS DEVELOPMENT
Name	:	PAUL VASILIAUSKAS
Credential	:
Telephone Number	:	602-971-6950

Provider Enumeration Date	:	03/30/2021
Last Update Date	:	03/30/2021

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Directions to “VASCO HEALTHCARE INC ” Practice Location

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