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General NPI Number Information
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NPI Number | 1013096171
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Entity Type | Organization
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Legal Business Name | AMERICAN CYTOPATHOLOGY SERVICES
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1301 DUNBAR AVENUE
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City | DUNBAR
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State | WV
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Zip | 25064-2920
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Country | US
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Telephone | 304-720-9791
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Fax | 304-720-9794
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Provider Business Mailing Address
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Address Line | 1301 DUNBAR AVENUE
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City | DUNBAR
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State | WV
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Zip | 25064-2920
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Country | US
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Telephone | 304-720-9791
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Fax | 304-720-9794
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Authorized Official
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Title or Position | OFFICE MANAGER BILLING MANAGER
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Name | MRS. JODIE B DOUGLAS
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Credential |
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Telephone | 304-720-7870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 05800732
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License Number State | WV
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