=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518837061
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TRUPATH LABS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/10/2025
-----------------------------------------------------
Last Update Date | 11/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 211 COMMERCE DR STE B
-----------------------------------------------------
City | BRANDON
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39042-2432
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 866-637-4675
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 209 COMMERCE DR STE C
-----------------------------------------------------
City | BRANDON
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39042-2756
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 601-594-3611
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/CEO
-----------------------------------------------------
Name | JERRY PAUL HUTCHINS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 601-594-3611
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 291U00000X
-----------------------------------------------------
Taxonomy Name | Clinical Medical Laboratory
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------