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General NPI Number Information
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NPI Number | 1548803315
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Entity Type | Organization
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Legal Business Name | ALTUS DIRECT HEALTHCARE LLC
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Dates
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Enumeration Date | 10/23/2019
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 3681 FISHINGER BLVD
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City | HILLIARD
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State | OH
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Zip | 43026-9552
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Country | US
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Telephone | 161-479-5937
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Fax |
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Provider Business Mailing Address
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Address Line | 600 W SANTA ANA BLVD STE 114A3055
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City | SANTA ANA
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State | CA
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Zip | 92701-4558
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Country | US
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Telephone | 614-971-0295
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TAHA SUFYAN SYED
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Credential |
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Telephone | 614-971-0295
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PT0002X
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Taxonomy Name | Medical Toxicology (Emergency Medicine) Physician
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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 | 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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