Polk Medical Testing Solutions LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

POLK MEDICAL TESTING SOLUTIONS LLC

Practice address

3430 McKelvey Rd Ste L
Bridgeton, MO 63044-2556

Phone

(314) 475-5955

NPI assigned

Oct 7, 2020

Organization subpart

No

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

Authorized official

Name

Ebony Polk

Title

Owner

Phone

(314) 283-6129

Specialties & licenses 1

Addresses

Other names 1

• Polk Medical Testing Solutions LLC Other name

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

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602028800000",
    "number": "1962009498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3430 MCKELVEY RD STE L",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442556",
            "telephone_number": "314-475-5955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3430 MCKELVEY RD STE L",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442556",
            "telephone_number": "314-475-5955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLK MEDICAL TESTING SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-07",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A",
        "authorized_official_last_name": "POLK",
        "authorized_official_first_name": "EBONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-283-6129"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Polk Medical Testing Solutions LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Robin Piffins
• Giancarlo A. Pillot, M.D.
• Stephanie Nicole Piotter, ANP
• Darrell Martin Pitt, D.O.
• Polk Consumer Directed Services LLC
• Elizabeth Joy Polk, MSW
• Ryan J Pomajzl, M.D., P.T., A.T.,C.
• Emily Ponder, PHARMD
• Jaylahni-Tashon Mailena Pope
• Post-Acute Physicians of Missouri PC

• Clinical Medical Laboratory in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Clinical Medical Laboratory in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; 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.