| Organization Name: | LOGISTICS HEALTH INCORPORATED |
| NPI Number: | 1043668775 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STACEY SANTIAGO (NP) |
| Mailing Address: | 4201 Northview Dr Ste 410 Bowie |
| State: | MD US |
| Postal Code: | 207162668 |
| Phone Number: | 2406445570 |
| Fax Number: | |
| NPI Enumeration Date: | 06/03/2016 |
| NPI Last Update Date: | 06/03/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1100X |
| License Number: | R 187467 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Military/U.S. Coast Guard Outpatient |
| Taxonomy Definition: | The Defense Health Program or U.S. Coast Guard funded |