Provider Demographics
NPI:1295703627
Name:HYPERBARIC PHYSICIAN SERVICES LLC
Entity type:Organization
Organization Name:HYPERBARIC PHYSICIAN SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEBRUHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-313-4144
Mailing Address - Street 1:1670 SPRINGDALE DRIVE
Mailing Address - Street 2:UNIT 11-A, BOX 7
Mailing Address - City:CAMDEN
Mailing Address - State:SC
Mailing Address - Zip Code:29020-4162
Mailing Address - Country:US
Mailing Address - Phone:888-313-4144
Mailing Address - Fax:866-473-7550
Practice Address - Street 1:830 KEMPSVILLE RD
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3920
Practice Address - Country:US
Practice Address - Phone:757-261-4325
Practice Address - Fax:757-261-4347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-10
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC06239Medicare ID - Type Unspecified