Provider Demographics
NPI:1164007688
Name:PODEX LLC
Entity Type:Organization
Organization Name:PODEX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANANDKUMAR
Authorized Official - Middle Name:RANJITBHAI
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:646-234-0060
Mailing Address - Street 1:7802 ARBOR GROVE DR APT 336
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-1814
Mailing Address - Country:US
Mailing Address - Phone:646-234-0060
Mailing Address - Fax:
Practice Address - Street 1:651 N BROAD ST STE 205
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-6402
Practice Address - Country:US
Practice Address - Phone:646-234-0060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric