NPI Code Detail JSON Logo

1326482910 NPI number — OBX LABORATORIES, LLC

NPI Number: 1326482910
Health Care Provider/Practitioner: OBX LABORATORIES, LLC

Information about “1326482910” NPI (OBX LABORATORIES, LLC) exists in 1326482910 in HTML format HTML  |  1326482910 in plain Text format TXT  |  1326482910 in PDF (Portable Document Format) PDF  |  1326482910 in an XML format XML  formats.

NPI Number : 1326482910 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1326482910",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "OBX LABORATORIES, LLC",
    "ParentOrgTIN": null,
    "OrgName": "OBX LABORATORIES, 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": "1313 VALWOOD PKWY",
    "SecondLineMailingAddress": "SUITE 240",
    "MailingAddressCityName": "CARROLLTON",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "75006",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "940-220-7496",
    "MailingAddressFaxNumber": "866-731-1999",
    "FirstLinePracticeLocationAddress": "1313 VALWOOD PKWY",
    "SecondLinePracticeLocationAddress": "SUITE 240",
    "PracticeLocationAddressCityName": "CARROLLTON",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "75006",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "940-220-7496",
    "PracticeLocationAddressFaxNumber": "866-731-1999",
    "EnumerationDate": "04/25/2013",
    "LastUpdateDate": "07/20/2017",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "FOSSUM",
    "AuthorizedOfficialFirstName": "LYNN",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "CHIEF COMPLIANCE OFFICER/PRINCIPAL",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "888-644-0030",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "291U00000X",
        "TaxonomyName": "Clinical Medical Laboratory",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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