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General NPI Number Information
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NPI Number | 1871785998
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Entity Type | Organization
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Legal Business Name | PRO-MED, INC.
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Dates
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Enumeration Date | 08/13/2007
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Last Update Date | 08/13/2007
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Provider Practice Location Address
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Address Line | 321 HIGH ST
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City | ELLSWORTH
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State | ME
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Zip | 04605-2503
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Country | US
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Telephone | 207-667-6589
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Fax | 207-667-2589
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Provider Business Mailing Address
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Address Line | 197 WASHINGTON JCTN RD
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City | HANCOCK
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State | ME
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Zip | 04640-3103
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Country | US
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Telephone | 207-667-6589
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Fax | 207-667-2589
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Authorized Official
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Title or Position | PRESIDENT
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Name | DALE HADLOCK
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Credential |
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Telephone | 207-667-6589
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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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