1407273873 NPI number — MEDI-LYNX CARDIAC MONITORING, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407273873 NPI number — MEDI-LYNX CARDIAC MONITORING, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEDI-LYNX CARDIAC MONITORING, 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:
Provider Other Organization Name Type Code:
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:
1407273873
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/01/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6700 PINECREST DR
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
PLANO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75024-4263
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
855-847-0780
Provider Business Mailing Address Fax Number:
855-847-1023

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
251 RHODE ISLAND ST STE 111
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94103-5168
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
855-847-0780
Provider Business Practice Location Address Fax Number:
855-847-1023
Provider Enumeration Date:
03/24/2014

Additional Information

Authorized Official

Authorized Official Last Name:
BOGDAN
Authorized Official First Name:
ANDREW
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
855-847-0780

Provider Taxonomy Codes

  • Taxonomy code: 293D00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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