Provider Demographics
NPI:1982899555
Name:ACOMED HEALTH CARE CENTER
Entity Type:Organization
Organization Name:ACOMED HEALTH CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURE PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SAMSON
Authorized Official - Middle Name:
Authorized Official - Last Name:DENIS
Authorized Official - Suffix:
Authorized Official - Credentials:OMD:AP
Authorized Official - Phone:954-731-6300
Mailing Address - Street 1:2331 N STATE ROAD 7 STE 222
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33313-3773
Mailing Address - Country:US
Mailing Address - Phone:954-731-6300
Mailing Address - Fax:954-731-5777
Practice Address - Street 1:2331 N STATE ROAD 7 STE 222
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33313-3773
Practice Address - Country:US
Practice Address - Phone:954-731-6300
Practice Address - Fax:954-731-5777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2221305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization