Provider Demographics
NPI:1295823540
Name:AMERICAN HEALTH S, LLC
Entity Type:Organization
Organization Name:AMERICAN HEALTH S, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-919-5005
Mailing Address - Street 1:15712 SW 41ST ST
Mailing Address - Street 2:SUITES 16-20
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33331-1538
Mailing Address - Country:US
Mailing Address - Phone:954-919-5005
Mailing Address - Fax:954-919-5042
Practice Address - Street 1:15712 SW 41ST ST
Practice Address - Street 2:SUITES 16-20
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33331-1538
Practice Address - Country:US
Practice Address - Phone:954-919-5005
Practice Address - Fax:954-919-5042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL800001801291U00000X
FL80021538291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103G69575OtherMEDICARE PTAN
SCL00227Medicaid
FL064538901Medicaid
MD1835OtherMARYLAND STATE LICENSE
SCQ347240001OtherMEDICARE PTAN
MD21D2039533OtherMARYLAND CLIA
MD240453OtherMARYLAND PTAN
FL10D2217743OtherCLIA JACKSONVILLE FLORIDA
TN1521799Medicaid
VA190002129OtherMEDICARE PTAN
FL800001801OtherDAVIE, FL. STATE LICENSE NUMBER
FL10D0707800OtherCLIA ID NUMBER- DAVIE, FL
FL10D1504277OtherCLIA NO- PINELLAS PARL
TN44D2009082OtherCLIA
FL800021538OtherSTATE LAB LICENSE, PINELL
TN0000004191OtherLABORATORY LICENSE NUMBER
VA1295823540Medicaid
MD1669817474OtherMARYLAND MEDICAID NPI
MD42118Medicaid
SC42D1080642OtherCLIA
VA49D1100758OtherCLIA