Provider Demographics
NPI:1235823873
Name:KEMET HEALTH ONE LLC
Entity Type:Organization
Organization Name:KEMET HEALTH ONE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-256-1600
Mailing Address - Street 1:5413A BACKLICK RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22151-3915
Mailing Address - Country:US
Mailing Address - Phone:703-256-1600
Mailing Address - Fax:
Practice Address - Street 1:1037 ELM ST OFC 210
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1808
Practice Address - Country:US
Practice Address - Phone:703-256-1600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KEMET HEALTH ONE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty