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1972560548 NPI number — AUGUSTA LABORATORY, INC.

NPI Number: 1972560548
Health Care Provider/Practitioner: AUGUSTA LABORATORY, INC.

Information about “1972560548” NPI (AUGUSTA LABORATORY, INC.) exists in 1972560548 in HTML format HTML  |  1972560548 in plain Text format TXT  |  1972560548 in PDF (Portable Document Format) PDF  |  1972560548 in an XML format XML  formats.

NPI Number : 1972560548 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1972560548",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "AUGUSTA LABORATORY, INC.",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1223 AUGUSTA WEST PKWY",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "AUGUSTA",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "30909-1807",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "706-868-0472",
    "MailingAddressFaxNumber": "706-650-0848",
    "FirstLinePracticeLocationAddress": "1223 AUGUSTA WEST PKWY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "AUGUSTA",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "30909-1807",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "706-868-0472",
    "PracticeLocationAddressFaxNumber": "706-650-0848",
    "EnumerationDate": "04/27/2006",
    "LastUpdateDate": "08/22/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "SCHOLER",
    "AuthorizedOfficialFirstName": "JAN",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "LABORATORY DIRECTOR",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "PH.D.",
    "AuthorizedOfficialTelephoneNumber": "706-868-0472",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "291U00000X",
        "TaxonomyName": "Clinical Medical Laboratory",
        "LicenseNumber": "121-015",
        "LicenseNumberStateCode": "GA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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