MEDICARE: ALBANY PATHOLOGY ASSOCIATES PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory	047-015	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CL8506	OTHER	GA	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073637740
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALBANY PATHOLOGY ASSOCIATES PC

Provider Business Mailing Address
First Line	:	PO BOX 71385
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31708-1385
Country	:	US
Telephone Number	:	229-439-7170
Fax Number	:	229-431-0770

Provider Business Practice Location Address
First Line	:	1907 PALMYRA RD
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31701-1574
Country	:	US
Telephone Number	:	229-439-7170
Fax Number	:	229-431-0770

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	CHRISTINA HARROLD
Credential	:
Telephone Number	:	229-439-7170

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	07/31/2008

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Directions to “ALBANY PATHOLOGY ASSOCIATES PC ” Practice Location

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