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General NPI Number Information
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NPI Number | 1700825114
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Entity Type | Organization
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Legal Business Name | FRIENDS MEDICAL LABORATORY INC.
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 02/02/2015
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Provider Practice Location Address
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Address Line | 5820 SOUTHWESTERN BLVD
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City | BALTIMORE
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State | MD
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Zip | 21227-4402
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Country | US
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Telephone | 410-247-4417
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Fax | 410-247-4426
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Provider Business Mailing Address
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Address Line | 5820 SOUTHWESTERN BLVD
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City | BALTIMORE
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State | MD
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Zip | 21227-4402
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Country | US
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Telephone | 410-247-4417
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Fax | 410-247-4426
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MYRON E. SHIPLET
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Credential |
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Telephone | 410-247-4417
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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 | 168
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License Number State | MD
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