Organization
LONGFELLOW, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAD EVERETT LONGFELLOW D.C. (PRESIDENT)
(740) 392-4878
Entity
Organization
Contact information
Practice address
306 E HIGH ST, MOUNT VERNON, OH 43050-3420
(740) 392-4878
(740) 392-6894
Mailing address
306 E HIGH ST, MOUNT VERNON, OH 43050-3420
(740) 392-4878
(740) 392-6894
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
1575
OH
261QH0100X
Health Service Clinic/Center
1575
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000503889
ANTHEM PROVIDER #
OH
01
—
1912935859
RENDERING PROVIDER'S NPI #
OH
05
—
2719133
—
OH
Enumeration date
02/07/2008
Last updated
11/24/2009
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