Independent Provider

LBN: Independent Provider
Independent Provider is an health care organization with primary practice located at 5659 Troy Villa Blvd , Dayton OH 45424-2645. The organization recently has only one registered license in Managed Care Organizations / Preferred Provider Organization, which is considered as the primary health care specialty. Independent Provider can be contacted via phone (979) 451-3843, or through Lee, La'Tasha Denise via phone (979) 451-3843.

Contact Information

Primary practice address
5659 Troy Villa Blvd Dayton OH 45424-2645
Phone: (979) 451-3843
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Lee, La'Tasha Denise
Phone: (979) 451-3843

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Preferred Provider Organization 305R00000X

Profile Details

NPI number 1699178723
LBN Legal business name Independent Provider
DBA Doing business as
Authorized official Lee, La'Tasha Denise
Entity Organization
Organization subpart 1 No
Enumeration date Oct 3rd, 2014
Last updated Oct 3rd, 2014 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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