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General NPI Number Information
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NPI Number | 1255633996
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Entity Type | Organization
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Legal Business Name | FORTIER SUBSTANCE ABUSE TESTING, INC.
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Dates
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Enumeration Date | 12/01/2010
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Last Update Date | 12/01/2010
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Provider Practice Location Address
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Address Line | 2267 JACKSON DOWNS BLVD
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City | NASHVILLE
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State | TN
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Zip | 37214-2300
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Country | US
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Telephone | 615-883-6962
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Fax | 615-829-5885
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Provider Business Mailing Address
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Address Line | PO BOX 140088
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City | NASHVILLE
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State | TN
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Zip | 37214-0088
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Country | US
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Telephone | 615-883-6962
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Fax | 615-829-5885
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Authorized Official
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Title or Position | EXECUTIVE VICE PRESIDENT
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Name | MRS. NIKKI NEAL
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Credential |
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Telephone | 615-883-6962
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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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