Crescentox, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

CRESCENTOX, INC.

Practice address

16250 Northland Dr
Suite 135
Southfield, MI 48075

Phone

(248) 259-1510

Fax

(248) 809-9151

NPI assigned

May 18, 2015

Organization subpart

No

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

Authorized official

Name

John Jackson

Title

Owner

Phone

(248) 259-1510

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1431907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479427200000",
    "number": "1427436963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16250 NORTHLAND DR",
            "address_2": "SUITE 135",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48075",
            "telephone_number": "248-259-1510",
            "fax_number": "248-809-9151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16250 NORTHLAND DR",
            "address_2": "SUITE 135",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48075",
            "telephone_number": "248-259-1510",
            "fax_number": "248-809-9151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESCENTOX, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-18",
        "last_updated": "2016-11-18",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-259-1510"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Southfield, MI
• Providers in Southfield, MI by specialty
• Clinical Medical Laboratory in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2016; 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.