Ameripath Lubbock 501a Corporation

Organization Active NPI Clinical Medical Laboratory · Roswell, NM

NPI 1801033683 · NPPES record last updated Apr 24, 2015

Key facts

NPI
1801033683
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Medical Laboratory 291U00000X
Legal business name
AMERIPATH LUBBOCK 501A CORPORATION
Practice address
117 E 19TH St
Roswell, NM 88201-5151
Phone
(575) 627-7000
Fax
(575) 627-7007
NPI assigned
Jan 15, 2009
Reactivated
Sep 20, 2011
Organization subpart
Yes
Parent organization (as reported)
AMERIPATH INC

Authorized official

Name
Dr. Edward M Kramer, MD
Title
VP
Phone
(610) 550-3000

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

15132 Collections Ctr
Chicago, IL 60693

15132 Collections Ctr D
Chicago, IL 60693

207 N Union Ave
Ste F
Roswell, NM 88201
Phone (575) 627-2005

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Yes

Addresses

Primary practice location

117 E 19TH St
Roswell, NM 88201-5151

Mailing address

14275 Midway Rd
Suite 400
Addison, TX 75001-3614
Phone (214) 932-8029

Other identifiers

IdentifierTypeStateIssuer
07231083MedicaidNM

Other providers in Roswell, NM

All providers in Roswell, NM · Clinical Medical Laboratory in New Mexico

Sources for this page

Verify at the official NPI Registry.