Provider Demographics
NPI:1144274879
Name:LARGO MEDICAL CENTER, INC.
Entity type:Organization
Organization Name:LARGO MEDICAL CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-588-5251
Mailing Address - Street 1:11315 CORPORATE BLVD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-8344
Mailing Address - Country:US
Mailing Address - Phone:727-588-5800
Mailing Address - Fax:727-588-5906
Practice Address - Street 1:201 14TH ST SW
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-3133
Practice Address - Country:US
Practice Address - Phone:727-588-5800
Practice Address - Fax:727-588-5906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME185270000Medicaid
FL011974100Medicaid
LA1782131Medicaid
NY2848144Medicaid
MI404862785Medicaid
MA1003151Medicaid
GA000231679XMedicaid
030982500OtherBLACK LUNG
MI304862847Medicaid
ALHOS0248NMedicaid
FL000030936OtherHUMANA
SC11301BMedicaid
20211OtherWELLCARE/STAYWELL
NY00807254Medicaid
OH0683907Medicaid
FL576OtherBLUE CROSS
0068893OtherAETNA
MIHO00712Medicaid
20211OtherWELLCARE/STAYWELL
100248Medicare Oscar/Certification