Provider Demographics
NPI:1326759929
Name:LOGISTICAL MED AND BEYOND, LLC
Entity Type:Organization
Organization Name:LOGISTICAL MED AND BEYOND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHADON
Authorized Official - Middle Name:TIARA
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:803-837-8791
Mailing Address - Street 1:175 ASHEWICKE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-7058
Mailing Address - Country:US
Mailing Address - Phone:803-837-8791
Mailing Address - Fax:
Practice Address - Street 1:300 LONG POINTE LN STE 220-J
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-7543
Practice Address - Country:US
Practice Address - Phone:803-837-8791
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care