Provider Demographics
NPI:1326642083
Name:PATHNET, LLC
Entity Type:Organization
Organization Name:PATHNET, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BREGETTE
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-500-6767
Mailing Address - Street 1:5100 TALLEY RD STE 300
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-8040
Mailing Address - Country:US
Mailing Address - Phone:501-500-6767
Mailing Address - Fax:501-500-6681
Practice Address - Street 1:2889 W ASHTON BLVD STE 300
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-4968
Practice Address - Country:US
Practice Address - Phone:500-500-6640
Practice Address - Fax:501-500-6681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-24
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
No291U00000XLaboratoriesClinical Medical LaboratoryGroup - Single Specialty