1023102670 NPI number — LFCC, LLC

Table of content: (NPI 1023102670)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023102670 NPI number — LFCC, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LFCC, LLC
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:
LECHMAIER FAMILY CHIROPRACTIC CENTER
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:
1023102670
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/02/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1051 TOWN CENTER DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORANGE CITY
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32763-8360
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
386-775-3600
Provider Business Mailing Address Fax Number:
386-775-3602

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1051 TOWN CENTER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ORANGE CITY
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32763-8360
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
386-775-3600
Provider Business Practice Location Address Fax Number:
386-775-3602
Provider Enumeration Date:
10/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LECHMAIER
Authorized Official First Name:
TRICIA
Authorized Official Middle Name:
KEELAN
Authorized Official Title or Position:
PRESIDENT/ OWNER
Authorized Official Telephone Number:
407-834-2225

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  CH8504 , 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: 89068 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: K4913A . This is a "MEDICARE GROUP NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 118508100 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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