Provider Demographics
NPI:1508464850
Name:CARDINAL PATHOLOGY, PC
Entity Type:Organization
Organization Name:CARDINAL PATHOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:MACAULAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-945-7564
Mailing Address - Street 1:PO BOX #2725
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81602
Mailing Address - Country:US
Mailing Address - Phone:970-945-7564
Mailing Address - Fax:970-945-0563
Practice Address - Street 1:181 W. MEADOW DRIVE
Practice Address - Street 2:VAIL HEALTH
Practice Address - City:VAIL
Practice Address - State:CO
Practice Address - Zip Code:81657
Practice Address - Country:US
Practice Address - Phone:970-945-7564
Practice Address - Fax:970-945-0563
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARDINAL PATHOLOGY, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-09
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty