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NPI Code Detail

MEDICARE: JSW LABS, INC.

MEDICARE: JSW LABS, 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
1291U00000XClinical Medical Laboratory

General Provider Information

NPI Number : 1447662937
Entity Type Code : Organization
Provider Name (Legal Business Name) : JSW LABS, INC.
Provider Business Mailing Address
First Line : 603 VILLAGE BLVD STE 210
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33409-1972
Country : US
Telephone Number : 954-746-8232
Fax Number : 954-746-8231
Provider Business Practice Location Address
First Line : 603 VILLAGE BLVD STE 210
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33409-1972
Country : US
Telephone Number : 954-746-8232
Fax Number : 954-746-8231
Authorized Official
Title or Position : BILLING MANAGER
Name : THERESA SMITH
Credential :
Telephone Number : 954-746-8232
Provider Enumeration Date : 06/02/2014
Last Update Date : 07/08/2014

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