MEDICARE: SALINA PATHOLOGY LAB 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		KS

General Provider Information

NPI Number	:	1417020520
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SALINA PATHOLOGY LAB INC

Provider Business Mailing Address
First Line	:	1423 WEST CRAWFORD
Second Line	:
City	:	SALINA
State	:	KS
Zip	:	67401
Country	:	US
Telephone Number	:	785-820-8680
Fax Number	:	785-820-8695

Provider Business Practice Location Address
First Line	:	1423 WEST CRAWFORD
Second Line	:
City	:	SALINA
State	:	KS
Zip	:	67401
Country	:	US
Telephone Number	:	785-820-8680
Fax Number	:	785-820-8695

Authorized Official
Title or Position	:	PATHOLOGIST
Name	:	DR. NORMAN E MACY
Credential	:	MD
Telephone Number	:	785-820-8680

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	08/22/2020

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