NPI Code Detail JSON Logo

1184449704 NPI number — RIVERSIDE MOBILE LABS LLC

NPI Number: 1184449704
Health Care Provider/Practitioner: RIVERSIDE MOBILE LABS LLC

Information about “1184449704” NPI (RIVERSIDE MOBILE LABS LLC) exists in 1184449704 in HTML format HTML  |  1184449704 in plain Text format TXT  |  1184449704 in PDF (Portable Document Format) PDF  |  1184449704 in an XML format XML  formats.

NPI Number : 1184449704 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1184449704",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "RIVERSIDE MOBILE LABS 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": "444 RIVER RD E",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "RUDOLPH",
    "MailingAddressStateName": "WI",
    "MailingAddressPostalCode": "54475-9563",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "715-423-1959",
    "MailingAddressFaxNumber": "715-304-2920",
    "FirstLinePracticeLocationAddress": "444 RIVER RD E",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "RUDOLPH",
    "PracticeLocationAddressStateName": "WI",
    "PracticeLocationAddressPostalCode": "54475-9563",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "715-423-1959",
    "PracticeLocationAddressFaxNumber": "715-304-2920",
    "EnumerationDate": "11/19/2024",
    "LastUpdateDate": "11/19/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "ZOPFI",
    "AuthorizedOfficialFirstName": "CAMI",
    "AuthorizedOfficialMiddleName": "L",
    "AuthorizedOfficialTitle": "OWNER/ PHLEBOTOMIST",
    "AuthorizedOfficialNamePrefix": "MRS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "PBT ASCP",
    "AuthorizedOfficialTelephoneNumber": "715-572-1959",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "291U00000X",
        "TaxonomyName": "Clinical Medical Laboratory",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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