Provider Demographics
NPI:1326606195
Name:BIOMOLECULAR INTEGRATIONS INC
Entity Type:Organization
Organization Name:BIOMOLECULAR INTEGRATIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AKHTAR
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-240-0339
Mailing Address - Street 1:119 COURTS LN
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-9018
Mailing Address - Country:US
Mailing Address - Phone:501-240-0339
Mailing Address - Fax:
Practice Address - Street 1:7481 WARDEN RD STE C
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:AR
Practice Address - Zip Code:72120-5041
Practice Address - Country:US
Practice Address - Phone:501-240-0339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-05
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR04D2166284OtherCLIA