Provider Demographics
NPI:1487247631
Name:LIGHTSEED LLC
Entity type:Organization
Organization Name:LIGHTSEED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMESHA
Authorized Official - Middle Name:LASELLE
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:DME
Authorized Official - Phone:414-249-9698
Mailing Address - Street 1:2323 S 109TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53227-1909
Mailing Address - Country:US
Mailing Address - Phone:414-249-9698
Mailing Address - Fax:
Practice Address - Street 1:2323 S 109TH ST
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53227-1909
Practice Address - Country:US
Practice Address - Phone:414-249-9698
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-18
Last Update Date:2021-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies