Provider Demographics
NPI:1083964050
Name:MEDWATCH, LLC
Entity Type:Organization
Organization Name:MEDWATCH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-333-8166
Mailing Address - Street 1:120 INTERNATIONAL PKWY
Mailing Address - Street 2:SUITE 220
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-5031
Mailing Address - Country:US
Mailing Address - Phone:407-333-8166
Mailing Address - Fax:407-333-8928
Practice Address - Street 1:120 INTERNATIONAL PKWY
Practice Address - Street 2:SUITE 220
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-5031
Practice Address - Country:US
Practice Address - Phone:407-333-8166
Practice Address - Fax:407-333-8928
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NMU, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management