# CENTER FOR VEIN RESTORATION IN, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629437397
- **Authorized official:** LORENA THOMAS (CREDENTIALING MANAGER)
- **Authorized official phone:** (815) 254-1761

## Contact information

- **Practice address:** 33 E COUNTY LINE RD STE D, GREENWOOD, IN 46143-1078
- **Practice address phone:** (855) 830-8346
- **Mailing address:** 7474 GREENWAY CENTER DR, SUITE 1000, GREENBELT, MD 20770-3504
- **Mailing address phone:** (240) 965-3258
- **Mailing address fax:** (240) 473-4321

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 02/23/2016
- **Last updated:** 06/18/2024