Provider Demographics
NPI:1053848044
Name:MID ATLANTIC BIO SOLUTIONS
Entity Type:Organization
Organization Name:MID ATLANTIC BIO SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:H
Authorized Official - Last Name:BLOCKSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-303-9923
Mailing Address - Street 1:9000 VIRGINIA MANOR RD STE 207
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-4214
Mailing Address - Country:US
Mailing Address - Phone:410-303-9923
Mailing Address - Fax:
Practice Address - Street 1:9000 VIRGINIA MANOR RD STE 207
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-4214
Practice Address - Country:US
Practice Address - Phone:954-496-2885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-22
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
0OtherOUT OF NETWORK PROVIDER ..