Provider Demographics
NPI:1861063935
Name:REAL SIMPLE HEALTHCARE LLC
Entity type:Organization
Organization Name:REAL SIMPLE HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ZAHID
Authorized Official - Middle Name:
Authorized Official - Last Name:RASHID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-518-0138
Mailing Address - Street 1:601 OLD WAGNER RD BLDG D
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23805-9313
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:601 OLD WAGNER RD BLDG D
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23805-9313
Practice Address - Country:US
Practice Address - Phone:607-425-1810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-08
Last Update Date:2021-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0101251701OtherLICENSE