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General NPI Number Information
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NPI Number | 1215527668
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Entity Type | Organization
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Legal Business Name | SSA VENTURES, LLC
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Dates
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Enumeration Date | 01/20/2021
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Last Update Date | 03/24/2022
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Provider Practice Location Address
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Address Line | 1714 CHARLESTOWN NEW ALBANY RD
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City | JEFFERSONVILLE
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State | IN
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Zip | 47130-9708
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Country | US
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Telephone | 812-271-4240
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Fax |
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Provider Business Mailing Address
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Address Line | 7000 AIRPORT DR
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City | SELLERSBURG
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State | IN
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Zip | 47172-2033
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHAWN HONAKER
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Credential |
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Telephone | 502-377-4751
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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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