Healthcare Provider Details

I. General information

NPI: 1578547055
Provider Name (Legal Business Name): SURGICAL PATHOLOGY SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 03/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 W BROAD ST
COLUMBUS OH
43228-1607
US

IV. Provider business mailing address

DEPT L2587 PO BOX 600001
COLUMBUS OH
43260-0001
US

V. Phone/Fax

Practice location:
  • Phone: 614-297-4000
  • Fax:
Mailing address:
  • Phone: 800-288-8325
  • Fax: 419-866-5453

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: DR. RUTH L. ANKER
Title or Position: PRESIDENT
Credential: D.O.
Phone: 614-297-4000