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1033544630 NPI number — ATLANTIC DIAGNOSTIC SERVICES, LLC

NPI Number: 1033544630
Health Care Provider/Practitioner: ATLANTIC DIAGNOSTIC SERVICES, LLC

Information about “1033544630” NPI (ATLANTIC DIAGNOSTIC SERVICES, LLC) exists in 1033544630 in HTML format HTML  |  1033544630 in plain Text format TXT  |  1033544630 in PDF (Portable Document Format) PDF  |  1033544630 in an XML format XML  formats.

NPI Number : 1033544630 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1033544630",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ATLANTIC DIAGNOSTIC SERVICES, LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1785 NONCONNAH BOULEVARD",
    "SecondLineMailingAddress": "SUITE 107",
    "MailingAddressCityName": "MEMPHIS",
    "MailingAddressStateName": "TN",
    "MailingAddressPostalCode": "38132-2140",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "662-449-8200",
    "MailingAddressFaxNumber": "888-891-3929",
    "FirstLinePracticeLocationAddress": "165 W SOUTH STREET",
    "SecondLinePracticeLocationAddress": "SUITE 202",
    "PracticeLocationAddressCityName": "HERNANDO",
    "PracticeLocationAddressStateName": "MS",
    "PracticeLocationAddressPostalCode": "38632-2266",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "855-717-6838",
    "PracticeLocationAddressFaxNumber": "888-371-4191",
    "EnumerationDate": "09/13/2013",
    "LastUpdateDate": "01/28/2014",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "PEREIRA",
    "AuthorizedOfficialFirstName": "JOHN",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "MANAGING MEMBER",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "662-469-3000",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "293D00000X",
        "TaxonomyName": "Physiological Laboratory",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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