Provider Demographics
NPI:1639404593
Name:RX DRUG MONITORING LABORATORY, LLC
Entity Type:Organization
Organization Name:RX DRUG MONITORING LABORATORY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:W
Authorized Official - Last Name:BOTTOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-866-9608
Mailing Address - Street 1:PO BOX 1420
Mailing Address - Street 2:660 LAKEWAY DRIVE SUITE A
Mailing Address - City:RUSSELL SPRINGS
Mailing Address - State:KY
Mailing Address - Zip Code:42642
Mailing Address - Country:US
Mailing Address - Phone:270-866-9608
Mailing Address - Fax:270-866-9609
Practice Address - Street 1:660 LAKEWAY DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:RUSSELL SPRINGS
Practice Address - State:KY
Practice Address - Zip Code:42642
Practice Address - Country:US
Practice Address - Phone:270-866-9608
Practice Address - Fax:270-866-9609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-11
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory