Provider Demographics
NPI:1659812501
Name:LLD CONNECT, LLC
Entity Type:Organization
Organization Name:LLD CONNECT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ERNST
Authorized Official - Middle Name:R
Authorized Official - Last Name:FISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-499-1037
Mailing Address - Street 1:4540 SHADY BLOSSOM LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43230-7546
Mailing Address - Country:US
Mailing Address - Phone:614-499-1037
Mailing Address - Fax:
Practice Address - Street 1:4540 SHADY BLOSSOM LN
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43230-7546
Practice Address - Country:US
Practice Address - Phone:614-499-1037
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-12
Last Update Date:2017-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage