Provider Demographics
NPI:1508517624
Name:APACE LAB SERVICES LLC
Entity Type:Organization
Organization Name:APACE LAB SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NIYONU
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDOWELL-WHARTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:864-867-7070
Mailing Address - Street 1:PO BOX 9042
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29604-9042
Mailing Address - Country:US
Mailing Address - Phone:864-907-4525
Mailing Address - Fax:
Practice Address - Street 1:3372 PEACHTREE RD NE STE 115
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30326-1881
Practice Address - Country:US
Practice Address - Phone:404-236-6096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service