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General NPI Number Information
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NPI Number | 1558614388
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Entity Type | Organization
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Legal Business Name | SCREENING FOR LIFE LLC
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Dates
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Enumeration Date | 10/17/2012
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Last Update Date | 04/08/2021
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Provider Practice Location Address
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Address Line | 6410 BUFFALO GAP RD #C
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City | ABILENE
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State | TX
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Zip | 79606-6055
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Country | US
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Telephone | 325-692-4410
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2754
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City | ABILENE
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State | TX
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Zip | 79604-2754
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Country | US
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Telephone | 325-692-4410
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MICHELE LEE
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Credential |
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Telephone | 325-692-4410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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