Provider Demographics
NPI:1356644397
Name:SANMED LLC
Entity Type:Organization
Organization Name:SANMED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER /DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCCOOMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-371-1531
Mailing Address - Street 1:8000 MADISON BLVD
Mailing Address - Street 2:SUITE D 102-291
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-2031
Mailing Address - Country:US
Mailing Address - Phone:812-371-1531
Mailing Address - Fax:256-325-8432
Practice Address - Street 1:8000 MADISON BLVD
Practice Address - Street 2:SUITE D 102-291
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-2031
Practice Address - Country:US
Practice Address - Phone:812-371-1531
Practice Address - Fax:256-325-8432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-14
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty