Basic Information
| Provider Information | |||||||||
| NPI: | 1902200488 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LEMAK HEALTH, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2316 1ST AVE S | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352332414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2053297510 | ||||||||
| FaxNumber: | 2053297536 | ||||||||
| Practice Location | |||||||||
| Address1: | 2316 1ST AVE S | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352332414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2053297510 | ||||||||
| FaxNumber: | 2053297536 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2014 | ||||||||
| LastUpdateDate: | 10/13/2014 | ||||||||
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| AuthorizedOfficialLastName: | LEMAK | ||||||||
| AuthorizedOfficialFirstName: | MATTHEW | ||||||||
| AuthorizedOfficialMiddleName: | T | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 2053297510 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | Y | 193200000X MULTI-SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.