Advanced Vascular Therapy Llc

LBN: Advanced Vascular Therapy Llc
Advanced Vascular Therapy Llc is an health care organization with primary practice located at 2480 Liberty St Ne Suite 110, Salem OR 97301-8380. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as the primary health care specialty. Advanced Vascular Therapy Llc can be contacted via phone (503) 371-1756, or through Roseborough, Glen S via phone (503) 371-1756.

Contact Information

Primary practice address
2480 Liberty St Ne Suite 110 Salem OR 97301-8380
Phone: (503) 371-1756
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Roseborough, Glen S Doctor of Medicine (MD)
Phone: (503) 371-1756

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X MD150190 Oregon

Profile Details

NPI number 1356726418
LBN Legal business name Advanced Vascular Therapy Llc
DBA Doing business as
Authorized official Roseborough, Glen S Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 29th, 2015
Last updated Nov 20th, 2015 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356726418 NPPES
Oregon MEDICAID 599512556

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