Provider Demographics
NPI:1073837019
Name:LONG BEACH MEDICAL CENTER
Entity Type:Organization
Organization Name:LONG BEACH MEDICAL CENTER
Other - Org Name:LONG BEACH MEDICAL CENTER DIALYSIS UNIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-897-1212
Mailing Address - Street 1:455 E BAY DR
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-2301
Mailing Address - Country:US
Mailing Address - Phone:516-897-1000
Mailing Address - Fax:516-897-1214
Practice Address - Street 1:455 E BAY DR
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-2301
Practice Address - Country:US
Practice Address - Phone:516-897-1000
Practice Address - Fax:516-897-1214
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LONG BEACH MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-19
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital