Basic Information
Provider Information
NPI: 1952352478
EntityType: 2
ReplacementNPI:  
OrganizationName: RAYTEL CARDIAC SERVICES, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: REMOTE CARDIAC SERVICES
OtherOrganizationType: 3
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 19387 US HIGHWAY 19 N
Address2: ATTN: COMPLIANCE
City: CLEARWATER
State: FL
PostalCode: 337643102
CountryCode: US
TelephoneNumber: 8002842006
FaxNumber:  
Practice Location
Address1: 29 GRIFFIN RD S STE 35
Address2:  
City: BLOOMFIELD
State: CT
PostalCode: 06002
CountryCode: US
TelephoneNumber: 8608761010
FaxNumber: 8665564411
Other Information
ProviderEnumerationDate: 05/12/2006
LastUpdateDate: 07/23/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: MCCARTHY
AuthorizedOfficialFirstName: GREGORY
AuthorizedOfficialMiddleName: G
AuthorizedOfficialTitleorPosition: CHIEF OPERATING OFFICER
AuthorizedOfficialTelephone: 7275307700
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 07/23/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
293D00000X  N LaboratoriesPhysiological Laboratory 
332B00000X  N SuppliersDurable Medical Equipment & Medical Supplies 
291U00000X  Y LaboratoriesClinical Medical Laboratory 

No ID Information.


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