Provider Demographics
NPI:1760009831
Name:NATIONAL ANCILLARY NETWORK SOLUTIONS, LLC
Entity Type:Organization
Organization Name:NATIONAL ANCILLARY NETWORK SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOOLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-803-9992
Mailing Address - Street 1:11161 STATE ROAD 70 E UNIT 110
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-9407
Mailing Address - Country:US
Mailing Address - Phone:813-803-9990
Mailing Address - Fax:813-803-9993
Practice Address - Street 1:10084 CHERRY HILLS AVENUE CIR
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34202-4063
Practice Address - Country:US
Practice Address - Phone:813-803-9990
Practice Address - Fax:813-803-9993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-06
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service