Provider Demographics
NPI:1376716886
Name:COLD SPRINGS MEDICAL LABORATORY
Entity Type:Organization
Organization Name:COLD SPRINGS MEDICAL LABORATORY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:L
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-643-6462
Mailing Address - Street 1:3228 COLD SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:16652-2721
Mailing Address - Country:US
Mailing Address - Phone:814-643-6462
Mailing Address - Fax:814-643-0435
Practice Address - Street 1:3228 COLD SPRINGS RD
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:16652-2721
Practice Address - Country:US
Practice Address - Phone:814-643-6462
Practice Address - Fax:814-643-0435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-04
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA000710291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA302377Medicare PIN