Basic Information
| Provider Information | |||||||||
| NPI: | 1215122742 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SPRINGHILL MEDICAL SERVICES INC | ||||||||
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| OtherOrganizationName: | SPRINGHILL PHYSICAL THERAPY, LLC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2001 DOCTORS DRIVE | ||||||||
| Address2: | |||||||||
| City: | SPRINGHILL | ||||||||
| State: | LA | ||||||||
| PostalCode: | 710754526 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3185391001 | ||||||||
| FaxNumber: | 3185394085 | ||||||||
| Practice Location | |||||||||
| Address1: | 206 REYNOLDS ST | ||||||||
| Address2: | |||||||||
| City: | SPRINGHILL | ||||||||
| State: | LA | ||||||||
| PostalCode: | 710753444 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3185394006 | ||||||||
| FaxNumber: | 3185394008 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/07/2007 | ||||||||
| LastUpdateDate: | 01/11/2018 | ||||||||
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| AuthorizedOfficialLastName: | SEDMINIK | ||||||||
| AuthorizedOfficialFirstName: | VINCENT | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF EXECUTIVE OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 3185391001 | ||||||||
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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 | 225X00000X | OOT.Z11094 | LA | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 225100000X | 00222R | LA | Y | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.