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General NPI Number Information
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NPI Number | 1760576755
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Entity Type | Organization
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Legal Business Name | PHARMASAN LABS INC
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 375 280TH ST
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City | OSCEOLA
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State | WI
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Zip | 54020-4120
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Country | US
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Telephone | 715-294-2144
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Fax | 715-294-2006
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Provider Business Mailing Address
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Address Line | 375 280TH ST
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City | OSCEOLA
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State | WI
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Zip | 54020-4120
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Country | US
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Telephone | 715-294-2144
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Fax | 715-294-2006
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | DR. GOTTFRIED KELLERMANN
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Credential | PHD
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Telephone | 715-294-2144
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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 | WI
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