Provider Demographics
NPI:1548803315
Name:ALTUS DIRECT HEALTHCARE LLC
Entity Type:Organization
Organization Name:ALTUS DIRECT HEALTHCARE LLC
Other - Org Name:ALTUS DIRECT HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:ABDIRAHIM
Authorized Official - Middle Name:
Authorized Official - Last Name:RASHID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-795-9378
Mailing Address - Street 1:3681 FISHINGER BLVD
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-9552
Mailing Address - Country:US
Mailing Address - Phone:614-541-9001
Mailing Address - Fax:
Practice Address - Street 1:3681 FISHINGER BLVD
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-9552
Practice Address - Country:US
Practice Address - Phone:161-479-5937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-23
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No207PT0002XAllopathic & Osteopathic PhysiciansEmergency MedicineMedical ToxicologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0391775Medicaid