1881979888 NPI number — GALAXY DIAGNOSTICS, INC.

Table of content: (NPI 1881979888)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881979888 NPI number — GALAXY DIAGNOSTICS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GALAXY DIAGNOSTICS, 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:
1881979888
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/02/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 14346
Provider Second Line Business Mailing Address:
7020 KIT CREEK RD, SUITE 130
Provider Business Mailing Address City Name:
RESEARCH TRIANGLE PARK
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27709-4346
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-313-9672
Provider Business Mailing Address Fax Number:
919-287-2476

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7020 KIT CREEK RD
Provider Second Line Business Practice Location Address:
SUITE 130
Provider Business Practice Location Address City Name:
MORRISVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27560-9761
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-313-9672
Provider Business Practice Location Address Fax Number:
919-287-2476
Provider Enumeration Date:
10/21/2011

Additional Information

Authorized Official

Authorized Official Last Name:
ELAM
Authorized Official First Name:
AMANDA
Authorized Official Middle Name:
B.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
919-313-9672

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  34D2027997 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com