Provider Demographics
NPI:1053756676
Name:AMERICAN HEALTH S, LLC
Entity type:Organization
Organization Name:AMERICAN HEALTH S, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIST
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-919-5005
Mailing Address - Street 1:15712 SW 41ST ST
Mailing Address - Street 2:SUITE 16-20
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33331-1538
Mailing Address - Country:US
Mailing Address - Phone:954-919-5005
Mailing Address - Fax:954-919-5042
Practice Address - Street 1:15712 SW 41ST ST
Practice Address - Street 2:SUITE 16-20
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33331-1538
Practice Address - Country:US
Practice Address - Phone:954-919-5005
Practice Address - Fax:954-919-5042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-09
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLL8597OtherMEDICARE PTAN
FL8000001801OtherSTATE LABORATORY LICENSE
FL064538901Medicaid
FL10D0707800OtherCLIA CERTIFICATE