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General NPI Number Information
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NPI Number | 1417193343
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Entity Type | Organization
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Legal Business Name | THE SPRINGS MEDICAL LABORATORY,LLC
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Dates
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Enumeration Date | 12/23/2008
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Last Update Date | 02/13/2009
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Provider Practice Location Address
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Address Line | 2200 E PARRISH AVE BUILDING 1 SUITE 102
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City | OWENSBORO
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State | KY
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Zip | 42303-1449
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Country | US
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Telephone | 270-683-9771
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 E PARRISH AVE BUILDING 1 SUITE 102
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City | OWENSBORO
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State | KY
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Zip | 42303-1449
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Country | US
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Telephone | 270-683-9771
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOHN E MCNULTY JR.
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Credential |
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Telephone | 270-683-9771
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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 | 200305
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License Number State | KY
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