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NPI Code Detail

MEDICARE: ADVANCED LABORATORY SERVICES, INC.

MEDICARE: ADVANCED LABORATORY SERVICES, 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
1251E00000XHome Health Agency
2251K00000XPublic Health or Welfare Agency
3291U00000XClinical Medical Laboratory00000000MD

General Provider Information

NPI Number : 1841638608
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED LABORATORY SERVICES, INC.
Provider Business Mailing Address
First Line : PO BOX 5312
Second Line :
City : LUTHERVILLE
State : MD
Zip : 21094-5312
Country : US
Telephone Number : 410-864-8181
Fax Number : 410-864-8149
Provider Business Practice Location Address
First Line : 1498 REISTERSTOWN RD
Second Line : #207
City : PIKESVILLE
State : MD
Zip : 21208-3817
Country : US
Telephone Number : 410-864-8181
Fax Number : 410-864-8149
Authorized Official
Title or Position : PRESIDENT/CEO
Name : MS. MONIQUE N. REID
Credential :
Telephone Number : 410-864-8181
Provider Enumeration Date : 06/13/2013
Last Update Date : 08/09/2013

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