# LIFELINE VASCULAR CENTER - ALBANY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Vascular Health & Wellness Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861730855
- **Authorized official:** JASON LOHMEYER (CFO)
- **Authorized official phone:** (847) 949-3855

## Contact information

- **Practice address:** 2300 DAWSON RD STE 100, ALBANY, GA 31707-2804
- **Practice address phone:** (229) 888-6466
- **Practice address fax:** (229) 888-5464
- **Mailing address:** 1 PARKWAY NORTH BLVD STE 200S, DEERFIELD, IL 60015-2534
- **Mailing address phone:** (847) 388-2001
- **Mailing address fax:** (847) 388-2020

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RN0300X | Nephrology Physician | — | NULL | — |
| 207RN0300X | Nephrology Physician | — | — | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | — |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/25/2013
- **Last updated:** 02/19/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 003134472A | — | GA |