Provider Demographics
NPI:1336899194
Name:LANTZ MEDICAL, INC.
Entity Type:Organization
Organization Name:LANTZ MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:ADDINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-536-4870
Mailing Address - Street 1:PO BOX 2153 DEPT 8031
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35287-8031
Mailing Address - Country:US
Mailing Address - Phone:317-536-4870
Mailing Address - Fax:317-536-4872
Practice Address - Street 1:4615 SHEPARD ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93313-2339
Practice Address - Country:US
Practice Address - Phone:317-536-4870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TL INDIANA HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-03-25
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier