Provider Demographics
NPI:1235431289
Name:CASTLE MEDICAL, LLC
Entity Type:Organization
Organization Name:CASTLE MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:M
Authorized Official - Last Name:DAMRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-486-7340
Mailing Address - Street 1:5700 HIGHLANDS PKWY SE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30082-5142
Mailing Address - Country:US
Mailing Address - Phone:678-486-7340
Mailing Address - Fax:678-486-7350
Practice Address - Street 1:5700 HIGHLANDS PKWY SE
Practice Address - Street 2:SUITE 100
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30082-5142
Practice Address - Country:US
Practice Address - Phone:678-486-7340
Practice Address - Fax:678-486-7350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-24
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory