Provider Demographics
NPI:1013231042
Name:HEALTHTRONICS LABORATORY SOLUTIONS LLC
Entity Type:Organization
Organization Name:HEALTHTRONICS LABORATORY SOLUTIONS LLC
Other - Org Name:UROPATH LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:A
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-314-4331
Mailing Address - Street 1:PO BOX 842184
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-2184
Mailing Address - Country:US
Mailing Address - Phone:512-314-4331
Mailing Address - Fax:
Practice Address - Street 1:100 KESTREL DR
Practice Address - Street 2:SUITE D
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-2060
Practice Address - Country:US
Practice Address - Phone:512-314-4331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-19
Last Update Date:2010-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA139235Medicare PIN