Provider Demographics
NPI:1427593177
Name:HEALTHONE LABS LLC
Entity Type:Organization
Organization Name:HEALTHONE LABS LLC
Other - Org Name:MED ONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:PITTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-206-7845
Mailing Address - Street 1:PO BOX 3730
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64803
Mailing Address - Country:US
Mailing Address - Phone:417-206-7845
Mailing Address - Fax:
Practice Address - Street 1:101 N RANGLINE RD
Practice Address - Street 2:304
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64801
Practice Address - Country:US
Practice Address - Phone:417-206-7845
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-04
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory