1578677142 NPI number — ADVANCED MEDICAL TESTING SYSTEMS, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578677142 NPI number — ADVANCED MEDICAL TESTING SYSTEMS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED MEDICAL TESTING SYSTEMS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578677142
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
235 DUNN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FLORISSANT
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63031-7928
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-837-2882
Provider Business Mailing Address Fax Number:
314-837-6465

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
235 DUNN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLORISSANT
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63031-7928
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-837-2882
Provider Business Practice Location Address Fax Number:
314-837-6465
Provider Enumeration Date:
08/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GREIWE
Authorized Official First Name:
JAN
Authorized Official Middle Name:
Authorized Official Title or Position:
VP/COO
Authorized Official Telephone Number:
314-837-5489

Provider Taxonomy Codes

  • Taxonomy code: 261QR0206X , with the licence number:  1217 CITY-FLORISSANT , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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