Healthcare Provider Details

I. General information

NPI: 1871555789
Provider Name (Legal Business Name): PATHOLOGY ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 09/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 E HAMPDEN AVE
ENGLEWOOD CO
80113-2702
US

IV. Provider business mailing address

PO BOX 30309
CHARLESTON SC
29417-0309
US

V. Phone/Fax

Practice location:
  • Phone: 303-788-6130
  • Fax:
Mailing address:
  • Phone: 843-554-9300
  • Fax: 843-566-8780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License Number
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number
License Number StateCO
# 4
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number StateCO

VIII. Authorized Official

Name: DR. JOHN EDWARD TRUELL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 303-788-6129