1841236684 NPI number — QUEST DIAGNOSTICS OF PENNSYLVANIA, INC.

Table of content: (NPI 1841236684)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841236684 NPI number — QUEST DIAGNOSTICS OF PENNSYLVANIA, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
QUEST DIAGNOSTICS OF PENNSYLVANIA, 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:
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:
1841236684
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/12/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14275 MIDWAY RD STE 400
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ADDISON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75001-3661
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
774-843-3062
Provider Business Mailing Address Fax Number:
610-271-4245

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
875 GREENTREE RD
Provider Second Line Business Practice Location Address:
FOUR PARKWAY CENTER
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15220-3610
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-295-6598
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BOWLES
Authorized Official First Name:
CHARLES
Authorized Official Middle Name:
ALBERT
Authorized Official Title or Position:
SR. VICE PRESIDENT
Authorized Official Telephone Number:
610-454-4122

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  39D0656976 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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