Provider Demographics
NPI:1568471514
Name:LONDON MEDICAL ARTS BLDG,INC.
Entity Type:Organization
Organization Name:LONDON MEDICAL ARTS BLDG,INC.
Other - Org Name:MEDICAL ARTS LABORATORY,INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:KAYE
Authorized Official - Last Name:ANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-864-9427
Mailing Address - Street 1:202 W 7TH ST
Mailing Address - Street 2:STE. 102
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40741-1763
Mailing Address - Country:US
Mailing Address - Phone:606-864-9427
Mailing Address - Fax:606-877-1604
Practice Address - Street 1:202 W 7TH ST
Practice Address - Street 2:STE. 102
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-1763
Practice Address - Country:US
Practice Address - Phone:606-864-9427
Practice Address - Fax:606-877-1604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY200063291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY37900289Medicaid
KY0018801Medicare ID - Type Unspecified