Mineral Area Laboratories LLC

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

Legal business name

MINERAL AREA LABORATORIES LLC

Practice address

1212 Weber Rd
Farmington, MO 63640-3325

Phone

(573) 756-4581

Fax

(573) 756-7197

NPI assigned

Dec 4, 2008

Last updated

Dec 4, 2008By 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

Russell Deidiker, MDNPI 1841265345

Title

Provider

Phone

(888) 275-9737

Specialties & licenses 1

Addresses

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.

• Russell D Deidiker, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Farmington, MO
  • NPI 1841265345
  Authorized official Same address or phone

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

{
    "created_epoch": "1228348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228348800000",
    "number": "1326283383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 78159",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631788159",
            "telephone_number": "800-354-1088",
            "fax_number": "314-845-5668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 WEBER RD",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636403325",
            "telephone_number": "573-756-4581",
            "fax_number": "573-756-7197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINERAL AREA LABORATORIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-04",
        "last_updated": "2008-12-04",
        "status": "A",
        "authorized_official_last_name": "DEIDIKER",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "888-275-9737",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keri Mills
• Brandin Lynn Milne-Gamm, BS CSS
• Mineral Area Community Psychiatric Rehabilitation Center, Inc.
• Mineral Area Community Psychiatric Rehabilitation Center, Inc.
• Mineral Area Health Services, Inc (Mineral Area Pharmacy-DME)
• Mineral Area Massage LLC (Mineral Area Massage)
• Mineral Area Osteopathic Hospital Inc (Mineral Area Regional Medical Center)
• Mineral Area Pain Center, P.C.
• Mineral Area Psychiatric Services LLC
• Peggy I. Minghi

• Anatomic Pathology & Clinical Pathology Physician in Farmington, MO
• Providers in Farmington, MO by specialty
• Anatomic Pathology & Clinical Pathology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2008; 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.