Provider Demographics
NPI:1578274940
Name:LNA CNA MEDCIAL SERVICES LLC
Entity Type:Organization
Organization Name:LNA CNA MEDCIAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER-MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:LNA, EMT
Authorized Official - Phone:602-314-1623
Mailing Address - Street 1:6825 S 7TH ST UNIT 91312
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85042-5440
Mailing Address - Country:US
Mailing Address - Phone:602-314-1623
Mailing Address - Fax:
Practice Address - Street 1:6825 S 7TH ST UNIT 91312
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-5440
Practice Address - Country:US
Practice Address - Phone:602-314-1623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient