Provider Demographics
NPI:1134512429
Name:ANCHORE LABORATORIES, INC
Entity Type:Organization
Organization Name:ANCHORE LABORATORIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SHAREHOLDER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUNOBI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-674-9147
Mailing Address - Street 1:3635 MOUNT HOLLY HUNTERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-8628
Mailing Address - Country:US
Mailing Address - Phone:336-269-4695
Mailing Address - Fax:
Practice Address - Street 1:3635 MOUNT HOLLY HUNTERSVILLE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28216-8628
Practice Address - Country:US
Practice Address - Phone:336-269-4695
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-10
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory