Provider Demographics
NPI:1447601695
Name:GRAVITY DIAGNOSTICS, LLC
Entity Type:Organization
Organization Name:GRAVITY DIAGNOSTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:REMINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-200-4882
Mailing Address - Street 1:812 RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41011-3165
Mailing Address - Country:US
Mailing Address - Phone:859-757-0158
Mailing Address - Fax:859-581-4086
Practice Address - Street 1:812 RUSSELL ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:KY
Practice Address - Zip Code:41011-3165
Practice Address - Country:US
Practice Address - Phone:859-757-0158
Practice Address - Fax:859-581-4086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-29
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory