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General NPI Number Information
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NPI Number | 1366776551
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Entity Type | Organization
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Legal Business Name | BRT LABORATORIES, INC.
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Dates
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Enumeration Date | 09/22/2009
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Last Update Date | 09/22/2009
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Provider Practice Location Address
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Address Line | 400 W FRANKLIN ST
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City | BALTIMORE
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State | MD
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Zip | 21201-1811
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Country | US
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Telephone | 410-225-9595
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Fax | 410-383-0938
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Provider Business Mailing Address
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Address Line | 400 W FRANKLIN ST
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City | BALTIMORE
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State | MD
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Zip | 21201-1811
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Country | US
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Telephone | 410-225-9595
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Fax | 410-383-0938
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RICHARD C HACKNEY JR.
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Credential |
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Telephone | 410-225-9595
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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 | 026
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License Number State | MD
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