Provider Demographics
NPI:1609202456
Name:ALTERNATIVE DIAGNOSTICS, LLC
Entity Type:Organization
Organization Name:ALTERNATIVE DIAGNOSTICS, LLC
Other - Org Name:EARTH'S WAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RUTHERFORD
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:972-808-7281
Mailing Address - Street 1:1705 W UNIVERSITY DR
Mailing Address - Street 2:STE 108
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-3392
Mailing Address - Country:US
Mailing Address - Phone:972-808-7281
Mailing Address - Fax:972-808-7253
Practice Address - Street 1:1705 W UNIVERSITY DR
Practice Address - Street 2:STE 108
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-3392
Practice Address - Country:US
Practice Address - Phone:972-808-7281
Practice Address - Fax:972-808-7253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX287653336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy