Provider Demographics
NPI:1073299012
Name:MADKO DIAGNOSTICS LLC.
Entity Type:Organization
Organization Name:MADKO DIAGNOSTICS LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED PHLEBOTOMIST/ OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AARIES
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:NCPT
Authorized Official - Phone:901-335-7181
Mailing Address - Street 1:7101 CHASE OAKS BLVD APT 121
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-5909
Mailing Address - Country:US
Mailing Address - Phone:901-335-7181
Mailing Address - Fax:972-666-0104
Practice Address - Street 1:7101 CHASE OAKS BLVD APT 121
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-5909
Practice Address - Country:US
Practice Address - Phone:901-335-7181
Practice Address - Fax:972-666-0104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty