Boots Diagnostic Lab, Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

BOOTS DIAGNOSTIC LAB, INC

Practice address

107 N Bridge St Ste B
Elkton, MD 21921-5326

Phone

(410) 392-6408

NPI assigned

Jan 29, 2019

Organization subpart

No

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

Authorized official

Name

Afshan Arif

Title

Managing Member

Phone

(443) 941-0504

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1548720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548720000000",
    "number": "1952865461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1250",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219221250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 N BRIDGE ST STE B",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219215326",
            "telephone_number": "410-392-6408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOOTS DIAGNOSTIC LAB, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-29",
        "last_updated": "2019-01-29",
        "status": "A",
        "authorized_official_last_name": "ARIF",
        "authorized_official_first_name": "AFSHAN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "443-941-0504"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori A Blair, CCC-SLP
• Olivia Blankenship
• Suanne Sentman Blumberg, M.S., L.P.C.
• Marissa Bodnar, MS CCC-SLP
• Nicollette Bolton, PHARMD
• Katie Bork, DPT
• Brooke Bower
• Colleen Bowers, PTA
• Cathy Bradford, LPN
• Marceline Eve Bradley, PT

• Clinical Medical Laboratory in Elkton, MD
• Providers in Elkton, MD by specialty
• Clinical Medical Laboratory in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2019; 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.