Provider Demographics
NPI:1467860833
Name:MERIDIAN APP MEDICAL SERVICES, LLC
Entity Type:Organization
Organization Name:MERIDIAN APP MEDICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BUSINESS SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:YATES
Authorized Official - Suffix:
Authorized Official - Credentials:CPC-10, CPC-H, CPC-I
Authorized Official - Phone:815-999-3001
Mailing Address - Street 1:2100 GLENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-5487
Mailing Address - Country:US
Mailing Address - Phone:815-725-2121
Mailing Address - Fax:815-741-6238
Practice Address - Street 1:1870 SILVER CROSS BLVD
Practice Address - Street 2:SUITE 240
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-8639
Practice Address - Country:US
Practice Address - Phone:815-514-2600
Practice Address - Fax:815-463-0964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty