Wilmington Pathology Laboratory Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

WILMINGTON PATHOLOGY LABORATORY INC

Practice address

1915 S 17TH St
Suite 100
Wilmington, NC 28401-6683

Phone

(910) 362-9511

NPI assigned

Nov 13, 2007

Organization subpart

No

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

Authorized official

Name

Brian C Shiro

Title

President

Phone

(910) 362-9511

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229299200000",
    "number": "1780864280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20169",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240180506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 S 17TH ST",
            "address_2": "SUITE 100",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016683",
            "telephone_number": "910-362-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILMINGTON PATHOLOGY LABORATORY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-13",
        "last_updated": "2008-12-15",
        "status": "A",
        "authorized_official_last_name": "SHIRO",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-362-9511"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NORTH CAROLINA",
            "identifier": "018F3",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7001334",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00627249",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Clinical Medical Laboratory in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.