Provider Demographics
NPI:1619371598
Name:SANITAS HEALTH CARE LLC
Entity Type:Organization
Organization Name:SANITAS HEALTH CARE LLC
Other - Org Name:EMPIRE TOXICOLOGY INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:SIVARAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-618-5600
Mailing Address - Street 1:PO BOX 732843
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-2843
Mailing Address - Country:US
Mailing Address - Phone:214-618-5600
Mailing Address - Fax:214-618-7733
Practice Address - Street 1:2422 ARBUCKLE CT
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75229-4506
Practice Address - Country:US
Practice Address - Phone:844-245-9714
Practice Address - Fax:888-509-2958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-21
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45D2084804291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45D2084804OtherCLIA