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NPI Code Detail

MEDICARE: EMPIRE DL OPERATOR LLC

MEDICARE: EMPIRE DL OPERATOR 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

General Provider Information

NPI Number : 1528502309
Entity Type Code : Organization
Provider Name (Legal Business Name) : EMPIRE DL OPERATOR LLC
Provider Business Mailing Address
First Line : 111 CLIFTON AVE
Second Line :
City : LAKEWOOD
State : NJ
Zip : 08701-3342
Country : US
Telephone Number : 214-396-3462
Fax Number : 214-396-3482
Provider Business Practice Location Address
First Line : 6160 SOUTH LOOP E
Second Line :
City : HOUSTON
State : TX
Zip : 77087-1010
Country : US
Telephone Number : 214-396-3462
Fax Number : 214-396-3482
Authorized Official
Title or Position : CEO
Name : JOE NEUMAN
Credential :
Telephone Number : 214-396-3462
Provider Enumeration Date : 12/13/2016
Last Update Date : 12/14/2016

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Directions to “EMPIRE DL OPERATOR LLC ” Practice Location

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