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General NPI Number Information
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NPI Number | 1821744905
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Entity Type | Organization
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Legal Business Name | PHARMA GENLABS, LLC
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Dates
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Enumeration Date | 02/27/2022
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Last Update Date | 05/18/2022
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Provider Practice Location Address
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Address Line | 8170 SOUTH AVE STE 3
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City | YOUNGSTOWN
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State | OH
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Zip | 44512-6434
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Country | US
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Telephone | 330-953-1093
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Fax |
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Provider Business Mailing Address
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Address Line | 8170 SOUTH AVE STE 3
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City | YOUNGSTOWN
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State | OH
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Zip | 44512-6434
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Country | US
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Telephone | 330-953-1093
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TIMOTHY CHEROTTI
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Credential |
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Telephone | 330-953-1093
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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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