Provider Demographics
NPI:1083043145
Name:RAYTEL CARDIAC SERVICES INC
Entity Type:Organization
Organization Name:RAYTEL CARDIAC SERVICES INC
Other - Org Name:REMOTE CARDIAC SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NANNIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-530-7700
Mailing Address - Street 1:19387 US HIGHWAY 19 N
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-3102
Mailing Address - Country:US
Mailing Address - Phone:727-431-8462
Mailing Address - Fax:877-524-9504
Practice Address - Street 1:535 ROUTE 38
Practice Address - Street 2:SUITE 500
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-2953
Practice Address - Country:US
Practice Address - Phone:800-242-7137
Practice Address - Fax:800-742-4582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-08
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
021418Medicare PIN