Provider Demographics
NPI:1578900882
Name:PHYSICIANS HEALTHCARE MANAGEMENT, LLC
Entity Type:Organization
Organization Name:PHYSICIANS HEALTHCARE MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GARETH
Authorized Official - Middle Name:D
Authorized Official - Last Name:REES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-445-7252
Mailing Address - Street 1:2703 GATEWAY DR
Mailing Address - Street 2:SUITE E1
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069-4327
Mailing Address - Country:US
Mailing Address - Phone:954-445-7252
Mailing Address - Fax:888-511-5924
Practice Address - Street 1:2703 GATEWAY DR
Practice Address - Street 2:SUITE E1
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-4327
Practice Address - Country:US
Practice Address - Phone:954-445-7252
Practice Address - Fax:888-511-5924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-28
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization