Provider Demographics
NPI:1346750494
Name:AMMON ANALYTICAL LABORATORIES LLC
Entity Type:Organization
Organization Name:AMMON ANALYTICAL LABORATORIES LLC
Other - Org Name:AMMON ANALYTICAL LABORATORIES LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAUPT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-862-4404
Mailing Address - Street 1:35 E BLANCKE ST
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-3180
Mailing Address - Country:US
Mailing Address - Phone:908-862-4404
Mailing Address - Fax:908-583-9997
Practice Address - Street 1:106 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:MA
Practice Address - Zip Code:01570-1756
Practice Address - Country:US
Practice Address - Phone:908-862-4404
Practice Address - Fax:908-583-9997
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMMON ANALYTICAL LABORATORIES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-03
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory