Provider Demographics
NPI:1629503974
Name:LAMPERT'S HOME THERAPY, INC.
Entity Type:Organization
Organization Name:LAMPERT'S HOME THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:PETROSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-541-5304
Mailing Address - Street 1:8254 118TH AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33773-5017
Mailing Address - Country:US
Mailing Address - Phone:727-541-5304
Mailing Address - Fax:727-546-8527
Practice Address - Street 1:8254 118TH AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33773-5017
Practice Address - Country:US
Practice Address - Phone:727-541-5304
Practice Address - Fax:727-546-8527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-25
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL830063100Medicaid