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General NPI Number Information
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NPI Number | 1669095600
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Entity Type | Organization
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Legal Business Name | AEON TECHNOLOGIES, LLC
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Dates
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Enumeration Date | 05/26/2020
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Last Update Date | 03/15/2023
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Provider Practice Location Address
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Address Line | 1 TECHNOLOGY DR STE 1600
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City | FROSTBURG
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State | MD
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Zip | 21532-2499
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Country | US
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Telephone | 240-284-2781
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Fax |
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Provider Business Mailing Address
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Address Line | 1 TECHNOLOGY DR STE 1600
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City | FROSTBURG
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State | MD
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Zip | 21532-2499
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Country | US
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Telephone | 240-284-2430
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. KIMBERLY BROWN
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Credential |
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Telephone | 240-463-3445
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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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