Provider Demographics
NPI:1225857501
Name:VASCULAR IMAGING SOLUTIONS LLC
Entity type:Organization
Organization Name:VASCULAR IMAGING SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HAGEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RVT
Authorized Official - Phone:602-930-1414
Mailing Address - Street 1:13660 N 94TH DRIVE
Mailing Address - Street 2:SUITE D-3
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4836
Mailing Address - Country:US
Mailing Address - Phone:480-450-4511
Mailing Address - Fax:602-960-1414
Practice Address - Street 1:13660 N 94TH DRIVE
Practice Address - Street 2:SUITE D-3
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4836
Practice Address - Country:US
Practice Address - Phone:480-450-4511
Practice Address - Fax:602-960-1414
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VASCULAR IMAGING SOLUTIONS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-04
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty