Provider Demographics
NPI:1316446057
Name:MY VEIN CARE, INC.
Entity type:Organization
Organization Name:MY VEIN CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING CONTACT
Authorized Official - Prefix:
Authorized Official - First Name:NINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:RIMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-252-3900
Mailing Address - Street 1:615 MARKET RD
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-9445
Mailing Address - Country:US
Mailing Address - Phone:304-252-3900
Mailing Address - Fax:304-252-9311
Practice Address - Street 1:3508 STAUNTON AVE SE FL 2
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1477
Practice Address - Country:US
Practice Address - Phone:304-926-1001
Practice Address - Fax:304-926-1003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-08
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1659202K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV5600616000Medicaid