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General NPI Number Information
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NPI Number | 1972561140
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Entity Type | Organization
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Legal Business Name | PATHOLOGY SERVICE CORPORATION
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 04/26/2025
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Provider Practice Location Address
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Address Line | 3902 OAKWOOD HILLS PKWY STE 2
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City | EAU CLAIRE
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State | WI
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Zip | 54701-7781
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Country | US
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Telephone | 715-858-3260
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Fax |
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Provider Business Mailing Address
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Address Line | 1235 MENOMONIE ST STE B
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City | EAU CLAIRE
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State | WI
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Zip | 54703-5974
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Country | US
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Telephone | 715-832-6445
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Fax |
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Authorized Official
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Title or Position | PATHOLOGIST - PRESIDENT
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Name | DR. ROBERT V RIDENOUR
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Credential | M.D.
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Telephone | 715-858-3260
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZB0001X
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Taxonomy Name | Blood Banking & Transfusion Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207ZD0900X
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Taxonomy Name | Dermatopathology (Pathology) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207ZH0000X
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Taxonomy Name | Hematology (Pathology) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207ZI0100X
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Taxonomy Name | Immunopathology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207ZN0500X
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Taxonomy Name | Neuropathology Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207ZP0104X
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Taxonomy Name | Chemical Pathology Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 207ZP0213X
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Taxonomy Name | Pediatric Pathology Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State |
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