Premiertox 2.0 Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PREMIERTOX 2.0 INC

Practice address

43 Waco Dr
#7
London, KY 40741-8327

Phone

(270) 866-5027

NPI assigned

Sep 8, 2014

Organization subpart

No

Name

Steven E Klipp

Title

President

Phone

(270) 866-8854

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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• Premiertox 2 0 Inc

  • Clinical Medical Laboratory
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  • NPI 1518356435

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• Premiertox 2.0 Inc

  • Clinical Medical Laboratory
  • Danville, KY
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• Premiertox 2.0 Inc.

  • Clinical Medical Laboratory
  • Campbellsville, KY
  • NPI 1649671827

  O20120319000741

  Same enrollment

Medicare fee-for-service enrollment

Enrolled in KY

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 8, 2015.

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431043200000",
    "number": "1932500121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 538512",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303538512",
            "telephone_number": "502-226-3858",
            "fax_number": "502-223-9829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 WACO DR",
            "address_2": "#7",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407418327",
            "telephone_number": "270-866-5027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERTOX 2.0 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-08",
        "last_updated": "2015-05-08",
        "status": "A",
        "authorized_official_last_name": "KLIPP",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "270-866-8854"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in London, KY
• Clinical Medical Laboratory in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.