Provider Demographics
NPI:1184472789
Name:SYCAMORE LAKELAND LLC
Entity type:Organization
Organization Name:SYCAMORE LAKELAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:SEMKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-710-9656
Mailing Address - Street 1:PO BOX 283
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35631-0283
Mailing Address - Country:US
Mailing Address - Phone:256-710-9656
Mailing Address - Fax:
Practice Address - Street 1:42024 AL-195
Practice Address - Street 2:
Practice Address - City:HALEYVILLE
Practice Address - State:AL
Practice Address - Zip Code:35565
Practice Address - Country:US
Practice Address - Phone:205-486-5213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty