Provider Demographics
NPI:1215122742
Name:SPRINGHILL MEDICAL SERVICES INC
Entity type:Organization
Organization Name:SPRINGHILL MEDICAL SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:R
Authorized Official - Last Name:SEDMINIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-539-1001
Mailing Address - Street 1:2001 DOCTORS DRIVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGHILL
Mailing Address - State:LA
Mailing Address - Zip Code:71075-4526
Mailing Address - Country:US
Mailing Address - Phone:318-539-1001
Mailing Address - Fax:318-539-4085
Practice Address - Street 1:206 REYNOLDS ST
Practice Address - Street 2:
Practice Address - City:SPRINGHILL
Practice Address - State:LA
Practice Address - Zip Code:71075-3444
Practice Address - Country:US
Practice Address - Phone:318-539-4006
Practice Address - Fax:318-539-4008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA00222R225100000X
LAOOT.Z11094225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CE77Medicare PIN