Healthcare Provider Details

I. General information

NPI: 1306080221
Provider Name (Legal Business Name): LASALLE HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2009
Last Update Date: 03/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1507 ATWOOD AVE
JOHNSTON RI
02919-3232
US

IV. Provider business mailing address

575 E WASHINGTON ST SUITE 1
NORTH ATTLEBORO MA
02760-2459
US

V. Phone/Fax

Practice location:
  • Phone: 401-331-5374
  • Fax: 401-331-5458
Mailing address:
  • Phone: 508-699-2090
  • Fax: 508-699-5932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. JON FREDERICK LOMBARDI
Title or Position: PRESIDENT
Credential:
Phone: 508-699-2090