Aca Laboratories

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

42D2043357 Issued in SC

Legal business name

ACA LABORATORIES

Practice address

113 Etiwan Dr
Goose Creek, SC 29445-3073

Phone

(843) 747-4294

Fax

(843) 747-4298

NPI assigned

Jul 29, 2011

Last updated

Jul 10, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Dimitri Zivko Pitovski, MDNPI 1588034144

Title

Ceo

Phone

(843) 747-4294

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dimitri Zivko Pitovski, MD

  • Otolaryngology Physician
  • Wilmington, NC
  • NPI 1588034144
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1311897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373414400000",
    "number": "1013295740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1726",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294451726",
            "telephone_number": "843-747-4294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 ETIWAN DR",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294453073",
            "telephone_number": "843-747-4294",
            "fax_number": "843-747-4298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACA LABORATORIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-29",
        "last_updated": "2013-07-10",
        "status": "A",
        "authorized_official_last_name": "PITOVSKI",
        "authorized_official_first_name": "DIMITRI",
        "authorized_official_middle_name": "ZIVKO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-747-4294",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "SC",
            "license": "42D2043357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Goose Creek, SC
• Providers in Goose Creek, SC by specialty
• Clinical Medical Laboratory in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.