Provider Demographics
NPI:1003042482
Name:MOBILE DRUG SCREEN
Entity Type:Organization
Organization Name:MOBILE DRUG SCREEN
Other - Org Name:ABSOLUTE HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:LEANOR
Authorized Official - Last Name:MCKNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-878-2321
Mailing Address - Street 1:239 W 13TH ST
Mailing Address - Street 2:
Mailing Address - City:BURLEY
Mailing Address - State:ID
Mailing Address - Zip Code:83318-1655
Mailing Address - Country:US
Mailing Address - Phone:208-878-2321
Mailing Address - Fax:208-878-9960
Practice Address - Street 1:239 W 13TH ST
Practice Address - Street 2:
Practice Address - City:BURLEY
Practice Address - State:ID
Practice Address - Zip Code:83318-1655
Practice Address - Country:US
Practice Address - Phone:208-878-2321
Practice Address - Fax:208-878-9960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-30
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory