Provider Demographics
NPI:1871131540
Name:SPAN HEALTH, INC
Entity type:Organization
Organization Name:SPAN HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:078-905-6427
Mailing Address - Street 1:HUCKLETREE, ALPHABETA BUILDING, 18 FINSBURY SQUARE
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:GREATER LONDON
Mailing Address - Zip Code:EC2A 1AH
Mailing Address - Country:GB
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:HUCKLETREE, ALPHABETA BUILDING, 18 FINSBURY SQUARE
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:GREATER LONDON
Practice Address - Zip Code:EC2A 1AH
Practice Address - Country:GB
Practice Address - Phone:078-890-5642
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-12
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, MetabolicGroup - Multi-Specialty
No133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight ManagementGroup - Multi-Specialty