Provider Demographics
NPI:1336282268
Name:TAYLOR MADE DIAGNOSTICS INC.
Entity Type:Organization
Organization Name:TAYLOR MADE DIAGNOSTICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MIDGETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-494-1688
Mailing Address - Street 1:1001 POINDEXTER ST
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23324-2444
Mailing Address - Country:US
Mailing Address - Phone:757-494-1688
Mailing Address - Fax:757-494-1973
Practice Address - Street 1:1001 POINDEXTER ST
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23324-2444
Practice Address - Country:US
Practice Address - Phone:757-494-1688
Practice Address - Fax:757-494-1973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine