1184679003 NPI number — ACCUMED HEALTH SERVICES, LP

Table of content: (NPI 1184679003)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184679003 NPI number — ACCUMED HEALTH SERVICES, LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACCUMED HEALTH SERVICES, LP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
A PLUS HEALTHCARE SPECIALISTS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184679003
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1983 MARCUS AVE
Provider Second Line Business Mailing Address:
STE 200
Provider Business Mailing Address City Name:
LAKE SUCCESS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11042-1016
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-358-1000
Provider Business Mailing Address Fax Number:
516-327-8636

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3300 SW 34TH AVE
Provider Second Line Business Practice Location Address:
UNIT 104
Provider Business Practice Location Address City Name:
OCALA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34474-7448
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-861-4931
Provider Business Practice Location Address Fax Number:
352-291-1752
Provider Enumeration Date:
05/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DERR
Authorized Official First Name:
WILLARD
Authorized Official Middle Name:
T
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
516-358-1000

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: JW6 . This is a "BC BS OF FLORIDA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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