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General NPI Number Information
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NPI Number | 1538020482
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Entity Type | Organization
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Legal Business Name | PROMINENT TOXICOLOGY SCREENINGS LLC
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Dates
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Enumeration Date | 11/20/2025
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 2030 REEVES ST
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City | MUSKOGEE
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State | OK
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Zip | 74401-4018
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Country | US
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Telephone | 918-351-0203
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Fax | 918-393-0018
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Provider Business Mailing Address
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Address Line | 2030 REEVES ST
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City | MUSKOGEE
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State | OK
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Zip | 74401-4018
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Country | US
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Telephone | 918-351-0203
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Fax | 918-393-0018
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Authorized Official
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Title or Position | OWNER
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Name | KEJONE DENSON
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Credential |
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Telephone | 918-441-0653
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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 |
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License Number State |
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