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NPI Code Detail

MEDICARE: CEDAR DIAGNOSTICS, LLC

MEDICARE: CEDAR DIAGNOSTICS, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1291U00000XClinical Medical Laboratory

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
106D2176866OTHERCOCLIA

General Provider Information

NPI Number : 1235768334
Entity Type Code : Organization
Provider Name (Legal Business Name) : CEDAR DIAGNOSTICS, LLC
Provider Business Mailing Address
First Line : 658 GRASSMERE PARK STE 104
Second Line :
City : NASHVILLE
State : TN
Zip : 37211-3683
Country : US
Telephone Number : 615-916-3200
Fax Number :
Provider Business Practice Location Address
First Line : 27B TALISMAN DR UNIT 3
Second Line :
City : PAGOSA SPRINGS
State : CO
Zip : 81147-7914
Country : US
Telephone Number : 970-372-0456
Fax Number : 970-507-3010
Authorized Official
Title or Position : PRESIDENT & CEO
Name : MR. ATHANASSIOS L. PAPAIOANU
Credential :
Telephone Number : 615-916-3200
Provider Enumeration Date : 04/02/2020
Last Update Date : 12/29/2021

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Directions to “CEDAR DIAGNOSTICS, LLC ” Practice Location

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