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General NPI Number Information
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NPI Number | 1518090448
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Entity Type | Organization
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Legal Business Name | ATHEROTECH, INC.
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 12/13/2012
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Provider Practice Location Address
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Address Line | 201 LONDON PARKWAY SUITE 400
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City | BIRMINGHAM
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State | AL
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Zip | 35211-4498
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Country | US
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Telephone | 800-719-9807
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Fax | 205-314-7404
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Provider Business Mailing Address
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Address Line | 201 LONDON PARKWAY SUITE 400
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City | BIRMINGHAM
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State | AL
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Zip | 35211-4498
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Country | US
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Telephone | 800-719-9807
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Fax | 205-314-7404
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Authorized Official
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Title or Position | CFO
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Name | MR. CHARLES A MUSIAL
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Credential |
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Telephone | 205-314-7506
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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 | 01D0641541
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 7587-L3733
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License Number State | AL
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