Provider Demographics
NPI:1093790008
Name:PRECISION PATHOLOGY PC
Entity Type:Organization
Organization Name:PRECISION PATHOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:NEUMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-432-7855
Mailing Address - Street 1:6429 MILLER ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004-2810
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6429 MILLER ST
Practice Address - Street 2:SUITE C
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80004-2810
Practice Address - Country:US
Practice Address - Phone:303-432-7855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
COF22142Medicare UPIN
CO441958Medicare ID - Type Unspecified