NPIMap

Organization Active NPI

Vitas Laboratory LLC

  • Clinical Medical Laboratory
  • Brunswick, GA
National Provider Identifier
1689183147
Registry record updated Sep 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
VITAS LABORATORY LLC
Practice address
702 7TH St
Brunswick, GA 31520-3249
Phone
(479) 434-5643
NPI assigned
Sep 27, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2017

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

Authorized official

Name
Billy Taylor
Title
Owner
Phone
(479) 353-5180

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

702 7TH St
Brunswick, GA 31520-3249

Mailing address

PO Box 23189
Barling, AR 72923-0189
Phone (479) 434-5643

National Provider Directory

National Provider Directory
Tax ID family
Vitas Laboratory LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

702 7th St
Brunswick, GA 31520

NPI Registry JSON

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

{
    "created_epoch": "1506470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506470400000",
    "number": "1689183147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23189",
            "city": "BARLING",
            "state": "AR",
            "postal_code": "729230189",
            "telephone_number": "479-434-5643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 7TH ST",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315203249",
            "telephone_number": "479-434-5643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAS LABORATORY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-27",
        "last_updated": "2017-09-27",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "BILLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-353-5180"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2017; 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.