Provider Demographics
NPI:1700224862
Name:SMARTMED - IT SOLUTIONS LLC
Entity Type:Organization
Organization Name:SMARTMED - IT SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:USHA
Authorized Official - Middle Name:
Authorized Official - Last Name:KRISHNAMOORTHY
Authorized Official - Suffix:
Authorized Official - Credentials:RHIA, CCS-P
Authorized Official - Phone:800-923-8835
Mailing Address - Street 1:114 STONESBERRY DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-5420
Mailing Address - Country:US
Mailing Address - Phone:800-923-8835
Mailing Address - Fax:337-593-8330
Practice Address - Street 1:155 HOSPITAL DR
Practice Address - Street 2:SUITE 103
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2852
Practice Address - Country:US
Practice Address - Phone:337-234-5541
Practice Address - Fax:337-593-8330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-11
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD204813207R00000X
WAMD60353692208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMD60353692OtherWA LICENSE