Provider Demographics
NPI:1437476298
Name:GREENS PATHOLOGY, P.C.
Entity Type:Organization
Organization Name:GREENS PATHOLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MARGARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOUZOVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:262-347-8216
Mailing Address - Street 1:1000 COWLES CLINIC WAY,
Mailing Address - Street 2:COWLES CLINIC, SUITE A-400
Mailing Address - City:GREENSBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30642
Mailing Address - Country:US
Mailing Address - Phone:706-550-0928
Mailing Address - Fax:706-550-0928
Practice Address - Street 1:4202 HANNAHS XING
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-8008
Practice Address - Country:US
Practice Address - Phone:262-347-8216
Practice Address - Fax:706-550-0928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA060396291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory