Provider Demographics
NPI:1376847863
Name:LOTUS HEALTH SERVICES
Entity Type:Organization
Organization Name:LOTUS HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:PRABHA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-951-9000
Mailing Address - Street 1:286 MONTEVUE LN
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-8212
Mailing Address - Country:US
Mailing Address - Phone:301-951-9000
Mailing Address - Fax:301-965-8731
Practice Address - Street 1:286 MONTEVUE LN
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-8212
Practice Address - Country:US
Practice Address - Phone:301-951-9000
Practice Address - Fax:301-965-8731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-27
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01289111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD9GGGDOtherCAREFIRST MD
DCQ989OtherCARE FIRST DC