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General NPI Number Information
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NPI Number | 1043271539
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Entity Type | Organization
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Legal Business Name | SMA MEDICAL, INC.
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Dates
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Enumeration Date | 04/01/2006
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Last Update Date | 05/24/2010
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Provider Practice Location Address
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Address Line | 940 PENNSYLVANIA BLVD UNIT E
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City | FEASTERVILLE
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State | PA
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Zip | 19053-7834
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Country | US
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Telephone | 215-322-6590
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Fax | 215-322-9524
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Provider Business Mailing Address
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Address Line | 940 PENNSYLVANIA BLVD UNIT E
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City | FEASTERVILLE
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State | PA
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Zip | 19053-7834
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Country | US
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Telephone | 215-322-6590
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Fax | 215-322-9524
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | MRS. KIRA ZHIVALYUK
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Credential |
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Telephone | 215-322-6590
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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 | 027649
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License Number State | PA
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