Provider Demographics
NPI:1598038226
Name:ORAL FLUID SERVICES OF PA
Entity Type:Organization
Organization Name:ORAL FLUID SERVICES OF PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:A
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-979-9772
Mailing Address - Street 1:139 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ALIQUIPPA
Mailing Address - State:PA
Mailing Address - Zip Code:15001-1623
Mailing Address - Country:US
Mailing Address - Phone:412-979-9772
Mailing Address - Fax:412-774-1615
Practice Address - Street 1:475 WILLOW CROSSING RD
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-9183
Practice Address - Country:US
Practice Address - Phone:412-979-9772
Practice Address - Fax:422-774-1615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-10
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory