Provider Demographics
NPI:1942717210
Name:PHYSICIAN'S MANAGED SERVICES
Entity Type:Organization
Organization Name:PHYSICIAN'S MANAGED SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRISH
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNS
Authorized Official - Suffix:
Authorized Official - Credentials:NRCMA
Authorized Official - Phone:813-961-0392
Mailing Address - Street 1:PO BOX 340147
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33694-0147
Mailing Address - Country:US
Mailing Address - Phone:813-562-6319
Mailing Address - Fax:
Practice Address - Street 1:14910 N DALE MABRY HWY # 340147
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33694-0147
Practice Address - Country:US
Practice Address - Phone:813-562-6319
Practice Address - Fax:813-961-0392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-08
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management