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General NPI Number Information
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NPI Number | 1487244364
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Entity Type | Organization
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Legal Business Name | LIGHTHOUSE COMMUNITY HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 01/25/2021
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Last Update Date | 06/05/2023
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Provider Practice Location Address
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Address Line | 1310 CHURCH ST
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City | LYNCHBURG
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State | VA
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Zip | 24504-4604
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Country | US
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Telephone | 434-847-5050
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Fax |
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Provider Business Mailing Address
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Address Line | 1310 CHURCH ST
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City | LYNCHBURG
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State | VA
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Zip | 24504-4604
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Country | US
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Telephone | 434-847-5050
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Fax |
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Authorized Official
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Title or Position | PREIDENT
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Name | MR. FINNY MATHEW
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Credential |
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Telephone | 434-847-5050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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