Provider Demographics
NPI:1477854701
Name:DIATECH ONCOLOGY LLC
Entity Type:Organization
Organization Name:DIATECH ONCOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-567-0200
Mailing Address - Street 1:405 DUKE DRIVE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067
Mailing Address - Country:US
Mailing Address - Phone:615-567-0200
Mailing Address - Fax:615-567-0201
Practice Address - Street 1:405 DUKE DRIVE
Practice Address - Street 2:SUITE 240
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067
Practice Address - Country:US
Practice Address - Phone:615-567-0200
Practice Address - Fax:615-567-0201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-03
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7186701 CAP291U00000X
TN99D1030993 CLIA291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory