Provider Demographics
NPI:1245561349
Name:AMERITOX, LLC
Entity Type:Organization
Organization Name:AMERITOX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:G
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-769-1606
Mailing Address - Street 1:300 E LOMBARD ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-3219
Mailing Address - Country:US
Mailing Address - Phone:443-220-0115
Mailing Address - Fax:443-769-1656
Practice Address - Street 1:486 GALLIMORE DAIRY RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27409-9725
Practice Address - Country:US
Practice Address - Phone:336-387-7600
Practice Address - Fax:336-387-7601
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERITOX, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-01-29
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory