Healthcare Provider Details

I. General information

NPI: 1518203645
Provider Name (Legal Business Name): TOXICOLOGY PARTNERS OF AMERICA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2012
Last Update Date: 12/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 S CEDAR ST SUITE 147
LITTLE ROCK AR
72205-5514
US

IV. Provider business mailing address

1324 CLARKSON CLAYTON CTR PO BOX 317
ELLISVILLE MO
63011-2145
US

V. Phone/Fax

Practice location:
  • Phone: 501-687-9220
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER HARTSHORN
Title or Position: VICE PRESIDENT
Credential:
Phone: 314-803-0330