Healthcare Provider Details

I. General information

NPI: 1386968675
Provider Name (Legal Business Name): OPANS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2010
Last Update Date: 11/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4134 S ALSTON AVE SUITE 102
DURHAM NC
27713-1870
US

IV. Provider business mailing address

4134 S ALSTON AVE SUITE 101
DURHAM NC
27713-1870
US

V. Phone/Fax

Practice location:
  • Phone: 919-323-4300
  • Fax:
Mailing address:
  • Phone: 919-323-4300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. JOHN D POWDERLY II
Title or Position: LABORATORY DIRECTOR
Credential: MD
Phone: 919-323-4300