Provider Demographics
NPI:1346833670
Name:MEIKLE MOBILE MEDICAL SUPPORT SERVICES
Entity Type:Organization
Organization Name:MEIKLE MOBILE MEDICAL SUPPORT SERVICES
Other - Org Name:ADVANCED HOME DIAGNOSTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WINSTON
Authorized Official - Middle Name:MALCOLM
Authorized Official - Last Name:MEIKLE
Authorized Official - Suffix:SR
Authorized Official - Credentials:MSN MBA CCRN
Authorized Official - Phone:201-682-2292
Mailing Address - Street 1:225 LARCH AVE
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-2345
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:225 LARCH AVE
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-2345
Practice Address - Country:US
Practice Address - Phone:866-242-3826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-17
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes293D00000XLaboratoriesPhysiological LaboratoryGroup - Multi-Specialty