Provider Demographics
NPI:1417283623
Name:AMERICAN FORENSIC TOXICOLOGY SERVICES LLC
Entity Type:Organization
Organization Name:AMERICAN FORENSIC TOXICOLOGY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR OF CREDENTIALING/ENROLLMENT
Authorized Official - Prefix:
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-304-7602
Mailing Address - Street 1:PO BOX 830525
Mailing Address - Street 2:#OWC 29
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35283-0525
Mailing Address - Country:US
Mailing Address - Phone:508-304-7602
Mailing Address - Fax:
Practice Address - Street 1:789 PARK AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-3912
Practice Address - Country:US
Practice Address - Phone:631-923-0166
Practice Address - Fax:720-403-8010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-22
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory