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General NPI Number Information
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NPI Number | 1154941284
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Entity Type | Organization
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Legal Business Name | ADVENTUS EDUCATION LLC
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Dates
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Enumeration Date | 04/18/2020
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Last Update Date | 04/18/2020
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Provider Practice Location Address
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Address Line | 4820 BUSINESS CENTER DR STE 100B
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City | FAIRFIELD
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State | CA
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Zip | 94534-1901
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Country | US
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Telephone | 707-927-0027
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Fax | 707-927-0027
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Provider Business Mailing Address
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Address Line | 4820 BUSINESS CENTER DR STE 100B
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City | FAIRFIELD
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State | CA
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Zip | 94534-1901
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Country | US
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Telephone | 707-927-0027
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Fax | 707-927-0027
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Authorized Official
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Title or Position | COO, OWNER
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Name | MICHAEL JOSEPH MCDEVITT
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Credential |
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Telephone | 707-363-6703
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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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