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General NPI Number Information
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NPI Number | 1033864467
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Entity Type | Organization
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Legal Business Name | ACCUMARK DIAGNOSTICS LLC
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Dates
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Enumeration Date | 02/14/2022
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Last Update Date | 07/28/2022
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Provider Practice Location Address
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Address Line | 115 W MAIN ST
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City | GREENTOWN
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State | IN
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Zip | 46936-1116
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Country | US
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Telephone | 765-627-4003
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Fax |
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Provider Business Mailing Address
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Address Line | 381 N 700 E
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City | GREENTOWN
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State | IN
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Zip | 46936-1058
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Country | US
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Telephone | 765-480-1832
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | JENNIFER LANNING
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Credential |
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Telephone | 765-480-1832
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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 |
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License Number State |
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