Provider Demographics
NPI:1083394563
Name:PRIMETIME LAB SOLUTIONS
Entity Type:Organization
Organization Name:PRIMETIME LAB SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:
Authorized Official - First Name:QUANZA
Authorized Official - Middle Name:
Authorized Official - Last Name:HIGHTOWER
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, APRN, WHNP-BC
Authorized Official - Phone:470-401-2445
Mailing Address - Street 1:5825 GLENRIDGE DR.
Mailing Address - Street 2:BUILDING 1, SUITE 214
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328
Mailing Address - Country:US
Mailing Address - Phone:470-401-2445
Mailing Address - Fax:
Practice Address - Street 1:5825 GLENRIDGE DR.
Practice Address - Street 2:BUILDING 1, SUITE 214
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328
Practice Address - Country:US
Practice Address - Phone:470-401-2445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-20
Last Update Date:2024-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory