Provider Demographics
NPI:1619232204
Name:ARCTICAX US LTD
Entity Type:Organization
Organization Name:ARCTICAX US LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:HINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:416-673-8476
Mailing Address - Street 1:801 BROADWAY AVE NW
Mailing Address - Street 2:SUITE 303
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49504-4462
Mailing Address - Country:US
Mailing Address - Phone:616-233-0622
Mailing Address - Fax:866-964-5184
Practice Address - Street 1:801 BROADWAY AVE NW
Practice Address - Street 2:SUITE 303
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49504-4462
Practice Address - Country:US
Practice Address - Phone:216-464-5160
Practice Address - Fax:866-964-5184
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARCTICAX INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-07-10
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory