Organization
LONG LIFE HEALTH CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAWRENCE EDWARD LONG CRTT (PRESIDENT)
(614) 240-4247
Entity
Organization
Contact information
Practice address
6475 E MAIN ST STE 130, REYNOLDSBURG, OH 43068-7320
(614) 240-4247
(614) 861-4247
Mailing address
6475 E MAIN ST STE 130, REYNOLDSBURG, OH 43068-7320
(614) 240-4247
(614) 861-4247
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
332BX2000X
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0262004
—
OH
Enumeration date
10/18/2006
Last updated
04/09/2009
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