Provider Demographics
NPI:1164475562
Name:LYMPHA MED
Entity Type:Organization
Organization Name:LYMPHA MED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-659-4139
Mailing Address - Street 1:6606 ABERCORN STREET
Mailing Address - Street 2:SUITE 119
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-5830
Mailing Address - Country:US
Mailing Address - Phone:912-355-1524
Mailing Address - Fax:912-228-4956
Practice Address - Street 1:6606 ABERCORN STREET
Practice Address - Street 2:SUITE 119
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-5830
Practice Address - Country:US
Practice Address - Phone:912-355-1524
Practice Address - Fax:912-228-4956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA446199332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies