Provider Demographics
NPI:1255636874
Name:SMART PAIN MANAGEMENT CONSULTING LLC
Entity type:Organization
Organization Name:SMART PAIN MANAGEMENT CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:IRA
Authorized Official - Middle Name:D
Authorized Official - Last Name:KORNBLUTH
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:443-605-0500
Mailing Address - Street 1:12607 BELMONT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-5674
Mailing Address - Country:US
Mailing Address - Phone:443-605-0500
Mailing Address - Fax:
Practice Address - Street 1:826 WASHINGTON RD
Practice Address - Street 2:SUITE 112
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157
Practice Address - Country:US
Practice Address - Phone:443-605-0500
Practice Address - Fax:443-605-0501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-12
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies