Organization Name: | VELNET 21 MEDICAL CLINIC |
NPI Number: | 1467888545 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MILAGRO SANCHEZ (CEO) |
Mailing Address: | 126 W. Mcconkey St. Shreve |
State: | OH US |
Postal Code: | 446769301 |
Phone Number: | 3307891099 |
Fax Number: | 3307891109 |
NPI Enumeration Date: | 09/19/2013 |
NPI Last Update Date: | 09/19/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QC1500X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Community Health |
Taxonomy Definition: |