Itl Pharma

NPI 1154716512 - Clinical Medical Laboratory - 291U00000X

NPI Details
NPI 1154716512
Enumeration Date 04/02/2015
Last Updated 04/02/2015
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name KEITH R KEITH
Position CEO
Phone (423) 444-1474
Fax
Practice Location
100 COLEY ST
KINGSPORT TN, 37660-1505, US
Phone (423) 444-1474
Fax
Business Location
100 COLEY ST
KINGSPORT TN, 37660-1505, US
Phone
Fax
Toxanomy
Taxonomy Code 291U00000X
License State Tennessee
License Number 00004115
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According to our database, Itl Pharma NPI is 1154716512, taxonomy code is 291U00000X and license number is 00004115, license state is located at Tennessee. Itl Pharma physically located at 100 Coley St, Kingsport TN, 37660-1505. NPI Number 1033115704 has the healthcare provider type.

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1154716512 NPI number is provided on an as is basis without warranty of any kind. 1154716512 is maintained by the National Plan & Provider Enumeration System. The contents of Itl Pharma are for informational purposes only.