Provider Demographics
NPI:1609284330
Name:TELEHEALTHONE, LLC
Entity Type:Organization
Organization Name:TELEHEALTHONE, LLC
Other - Org Name:LYNK HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:MOON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-859-4342
Mailing Address - Street 1:10 CANEBRAKE BLVD STE 110-018
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-2211
Mailing Address - Country:US
Mailing Address - Phone:601-859-4342
Mailing Address - Fax:
Practice Address - Street 1:10 CANEBRAKE BLVD STE 110-018
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-2211
Practice Address - Country:US
Practice Address - Phone:601-859-4342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-25
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No302F00000XManaged Care OrganizationsExclusive Provider OrganizationGroup - Multi-Specialty