Provider Demographics
NPI:1447685144
Name:VASCULAR CARE PC
Entity type:Organization
Organization Name:VASCULAR CARE PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MOREHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:641-231-1471
Mailing Address - Street 1:1301 COULEE RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-2160
Mailing Address - Country:US
Mailing Address - Phone:641-231-1471
Mailing Address - Fax:888-231-8658
Practice Address - Street 1:1306 4TH ST SW
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-2742
Practice Address - Country:US
Practice Address - Phone:800-955-8346
Practice Address - Fax:888-803-4893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-12
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI43865-20202K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebologyGroup - Single Specialty