Provider Demographics
NPI: | 1083412589 |
---|---|
Name: | LOCAL MEDICAL HEALTH SERVICES, P.C. |
Entity type: | Organization |
Organization Name: | LOCAL MEDICAL HEALTH SERVICES, P.C. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | WOODRUFF |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | BAUM |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 646-568-0193 |
Mailing Address - Street 1: | 4900 CENTENNIAL BOULEVARD |
Mailing Address - Street 2: | SUITE 300, BOX 104 |
Mailing Address - City: | NASHVILLE |
Mailing Address - State: | TN |
Mailing Address - Zip Code: | 37209 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 6230 JERICHO TPKE STE C |
Practice Address - Street 2: | |
Practice Address - City: | COMMACK |
Practice Address - State: | NY |
Practice Address - Zip Code: | 11725-2811 |
Practice Address - Country: | US |
Practice Address - Phone: | 631-735-6330 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2025-03-03 |
Last Update Date: | 2025-03-03 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty |
No | 261QI0500X | Ambulatory Health Care Facilities | Clinic/Center | Infusion Therapy |