Provider Demographics
NPI:1568174357
Name:LANE ELECTRONICS & ALARM SYSTEMS, INC.
Entity Type:Organization
Organization Name:LANE ELECTRONICS & ALARM SYSTEMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS RECEIVABLE
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNSDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-299-6070
Mailing Address - Street 1:1891 W FAIRBANKS AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4501
Mailing Address - Country:US
Mailing Address - Phone:407-299-6070
Mailing Address - Fax:
Practice Address - Street 1:1891 W FAIRBANKS AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4501
Practice Address - Country:US
Practice Address - Phone:407-299-6070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-23
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL113388200Medicaid