Provider Demographics
NPI:1275078164
Name:LIFEWORKS SERVICES, LLC
Entity Type:Organization
Organization Name:LIFEWORKS SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDE
Authorized Official - Middle Name:NOVEL
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:540-989-3618
Mailing Address - Street 1:2917 PENN FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-4304
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2917 PENN FOREST BLVD
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-4304
Practice Address - Country:US
Practice Address - Phone:540-989-3618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDICAL FACILITIES OF AMERICA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-12-30
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty