Terre Haute Medical Laboratory, Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

50000920A Issued in IN

Legal business name

TERRE HAUTE MEDICAL LABORATORY, INC

Doing business as

Medlab

Practice address

1606 N 7TH Street
Terre Haute, IN 47804-2706

Phone

(812) 244-0100

Fax

(812) 232-1517

NPI assigned

May 24, 2005

Last updated

Dec 2, 2010By 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

Mr. William D. Depond, M.D.NPI 1699741942

Title

President and Chief Medical Officer

Phone

(812) 244-0100

Specialties & licenses 1

Addresses

Other names 1

• MEDLAB Doing business as

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.

• William D Depond, M.D.

  • Clinical Pathology/Laboratory Medicine Physician
  • Terre Haute, IN
  • NPI 1699741942
  Authorized official Same address or phone

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291248000000",
    "number": "1275536195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9359",
            "address_2": "634 BEECH STREET",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478089359",
            "telephone_number": "812-244-0100",
            "fax_number": "812-232-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 N 7TH STREET",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478042706",
            "telephone_number": "812-244-0100",
            "fax_number": "812-232-1517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRE HAUTE MEDICAL LABORATORY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2010-12-02",
        "status": "A",
        "authorized_official_last_name": "DEPOND",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT AND CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "812-244-0100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IN",
            "license": "50000920A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDLAB",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Medical Laboratory in Terre Haute, IN
• Providers in Terre Haute, IN by specialty
• Clinical Medical Laboratory in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; 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.