Provider Demographics
NPI:1427110634
Name:IN VOGUE WOMENS CARE INC
Entity type:Organization
Organization Name:IN VOGUE WOMENS CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DR.
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:VIETA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:614-471-6700
Mailing Address - Street 1:4850 E. MAIN ST
Mailing Address - Street 2:STE 100
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213
Mailing Address - Country:US
Mailing Address - Phone:614-471-6700
Mailing Address - Fax:614-566-0779
Practice Address - Street 1:4850 E. MAIN ST
Practice Address - Street 2:STE 100
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213
Practice Address - Country:US
Practice Address - Phone:614-471-6700
Practice Address - Fax:614-566-0779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34008514174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2569402Medicaid
OHV14166061Medicare ID - Type Unspecified
OH2569402Medicaid