Organization
SUMMIT CARDIOVASCULAR CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS VAGANOS MD (PRESIDENT)
(610) 647-4260
Entity
Organization
Contact information
Practice address
255 W LANCASTER AVE, PAOLI, PA 19301-1763
(610) 647-4260
Mailing address
PO BOX 127, LANDISVILLE, PA 17538-0127
(800) 800-1617
(866) 759-5426
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1024357250001
—
PA
01
—
21425714
BLUE SHIELD OF PA
PA
Enumeration date
07/13/2010
Last updated
07/13/2010
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