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General NPI Number Information
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NPI Number | 1235680661
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Entity Type | Organization
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Legal Business Name | PGXL TECHNOLOGIES, LLC
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Dates
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Enumeration Date | 10/20/2016
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Last Update Date | 11/02/2016
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Provider Practice Location Address
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Address Line | 201 E JEFFERSON ST SUITE 201
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City | LOUISVILLE
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State | KY
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Zip | 40202-1246
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Country | US
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Telephone | 502-569-0321
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Fax |
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Provider Business Mailing Address
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Address Line | 201 E JEFFERSON ST SUITE 201
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City | LOUISVILLE
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State | KY
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Zip | 40202-1246
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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 | VP OPERATIONS
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Name | TERRY MINTON
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Credential |
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Telephone | 502-569-0321
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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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