Provider Demographics
NPI:1386045110
Name:AKSM/HEALTHCARE COLLABORATION SERVICES, LLC
Entity Type:Organization
Organization Name:AKSM/HEALTHCARE COLLABORATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BUERGENTHAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-298-8150
Mailing Address - Street 1:100 W 3RD AVE
Mailing Address - Street 2:SUITE 300R
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43201-3256
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 W 3RD AVE
Practice Address - Street 2:SUITE 300R
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43201-3256
Practice Address - Country:US
Practice Address - Phone:614-298-8150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-11
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty