Healthcare Provider Details

I. General information

NPI: 1194803395
Provider Name (Legal Business Name): PATHOLOGY SERVICE ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 05/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1362 CELEBRATION BLVD
FLORENCE SC
29501-5495
US

IV. Provider business mailing address

1362 CELEBRATION BLVD
FLORENCE SC
29501-5495
US

V. Phone/Fax

Practice location:
  • Phone: 800-832-5270
  • Fax: 843-664-4322
Mailing address:
  • Phone: 800-832-5270
  • Fax: 843-664-4322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code207ZI0100X
TaxonomyImmunopathology Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. BAMA SALTZMAN
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 800-832-5270