MEDICARE: ANAPATH DIAGNOSTICS, INC

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
1	291U00000X	Clinical Medical Laboratory		WY

General Provider Information

NPI Number	:	1386743169
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANAPATH DIAGNOSTICS, INC

Provider Business Mailing Address
First Line	:	PO BOX 205
Second Line	:
City	:	CHEYENNE
State	:	WY
Zip	:	82003-0205
Country	:	US
Telephone Number	:	307-634-9238
Fax Number	:	307-778-3665

Provider Business Practice Location Address
First Line	:	2301 HOUSE AVE STE 108
Second Line	:
City	:	CHEYENNE
State	:	WY
Zip	:	82001-3177
Country	:	US
Telephone Number	:	307-634-9238
Fax Number	:	307-778-3665

Authorized Official
Title or Position	:	MEDICAL PRACTICE MANAGER
Name	:	MS. CINDY L HEGNER
Credential	:	CCS
Telephone Number	:	307-634-9238

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	08/22/2020

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