Loyal Source Government Services

LBN: Loyal Source Government Services
Loyal Source Government Services is an health care organization with primary practice located at 3680 Avalon Park East Blvd Ste 310 , Orlando FL 32828-9374. The organization recently has only one registered license in Managed Care Organizations / Health Maintenance Organization, which is considered as the primary health care specialty. Loyal Source Government Services can be contacted via phone (407) 381-7734, or through Gambala, Vanessa via phone (619) 301-9112.

Contact Information

Primary practice address
3680 Avalon Park East Blvd Ste 310 Orlando FL 32828-9374
Phone: (407) 381-7734
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Gambala, Vanessa Nurse Practitioner (NP)
Phone: (619) 301-9112

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Health Maintenance Organization 302R00000X 95000947 California

Profile Details

NPI number 1487053864
LBN Legal business name Loyal Source Government Services
DBA Doing business as Loyal Source Government Services
Authorized official Gambala, Vanessa Nurse Practitioner (NP)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 21st, 2014
Last updated Aug 21st, 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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Identifiers

StateTypeNumberIssuer
All States NPI 1487053864 NPPES
California MEDICAID 95000947

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