Provider Demographics
NPI:1255836250
Name:MED-X HEALTH SERVICES
Entity Type:Organization
Organization Name:MED-X HEALTH SERVICES
Other - Org Name:MED-X HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:DOLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-777-4372
Mailing Address - Street 1:625 DELAWARE AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14202-1009
Mailing Address - Country:US
Mailing Address - Phone:716-777-4372
Mailing Address - Fax:
Practice Address - Street 1:625 DELAWARE AVE STE 101
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14202-1009
Practice Address - Country:US
Practice Address - Phone:716-777-4372
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PATIENT FIRST GROUP INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-03-29
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health