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General NPI Number Information
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NPI Number | 1760827141
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Entity Type | Organization
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Legal Business Name | HOLTER LABS, INC
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Dates
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Enumeration Date | 04/30/2013
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Last Update Date | 05/16/2014
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Provider Practice Location Address
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Address Line | 684 W SHILOH UNITY RD
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City | LANCASTER
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State | SC
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Zip | 29720-6803
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Country | US
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Telephone | 888-821-4667
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Fax | 888-821-4677
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Provider Business Mailing Address
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Address Line | PO BOX 25408
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City | PORTLAND
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State | OR
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Zip | 97298-0408
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Country | US
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Telephone | 888-821-4667
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Fax | 888-821-4677
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Authorized Official
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Title or Position | DME
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Name | MR. JAMES BROWN
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Credential |
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Telephone | 888-821-4667
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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 | 00089823
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 00059578
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 00089823
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License Number State | SC
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