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General NPI Number Information
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NPI Number | 1285811919
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Entity Type | Organization
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Legal Business Name | HOOSIER HISTOLOGY SERVICES
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Dates
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Enumeration Date | 01/24/2008
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Last Update Date | 01/24/2008
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Provider Practice Location Address
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Address Line | 8698 N COUNTY ROAD 200 E
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City | ORLEANS
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State | IN
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Zip | 47452-9503
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Country | US
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Telephone | 812-865-4475
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Fax |
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Provider Business Mailing Address
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Address Line | 8698 N COUNTY ROAD 200 E
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City | ORLEANS
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State | IN
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Zip | 47452-9503
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Country | US
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Telephone | 812-865-4475
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KATHY JEAN BAILEY
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Credential | MEDICAL DIRECTOR
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Telephone | 812-865-4475
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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 | 291U00000X
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License Number State | IN
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