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General NPI Number Information
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NPI Number | 1811306483
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Entity Type | Organization
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Legal Business Name | SUBSTANCE ABUSE TREATMENT LABS, LLC
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Dates
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Enumeration Date | 08/08/2014
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Last Update Date | 08/08/2014
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Provider Practice Location Address
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Address Line | 1100 REVOLUTION MILL DR SUITE 1
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City | GREENSBORO
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State | NC
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Zip | 27405-5067
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Country | US
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Telephone | 336-324-0550
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 REVOLUTION MILL DR SUITE 1
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City | GREENSBORO
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State | NC
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Zip | 27405-5067
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. PAUL FRIBUSH
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Credential |
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Telephone | 336-324-0550
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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 | 326822
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License Number State | NC
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