Provider Demographics
NPI:1073075602
Name:TOKEN MEDICAL SERVICES LLC
Entity Type:Organization
Organization Name:TOKEN MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TOCHUKWU
Authorized Official - Middle Name:C
Authorized Official - Last Name:ILOABUCHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-874-6826
Mailing Address - Street 1:6677 W MAY APPLE DR
Mailing Address - Street 2:
Mailing Address - City:MCCORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46055-4447
Mailing Address - Country:US
Mailing Address - Phone:317-426-1797
Mailing Address - Fax:317-613-7730
Practice Address - Street 1:6677 W MAY APPLE DR
Practice Address - Street 2:
Practice Address - City:MCCORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46055-4447
Practice Address - Country:US
Practice Address - Phone:317-426-1797
Practice Address - Fax:317-613-7730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service