Provider Demographics
NPI:1518364603
Name:CHOLESTCHECK CORP
Entity Type:Organization
Organization Name:CHOLESTCHECK CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:TROCKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-422-1201
Mailing Address - Street 1:110C AUGUSTA ARBOR WAY
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-5226
Mailing Address - Country:US
Mailing Address - Phone:864-422-1201
Mailing Address - Fax:864-422-1204
Practice Address - Street 1:110C AUGUSTA ARBOR WAY
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-5226
Practice Address - Country:US
Practice Address - Phone:864-422-1201
Practice Address - Fax:864-422-1204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-04
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
42D0929042Medicare Oscar/Certification