Provider Demographics
NPI:1639768898
Name:NEPHCARE LAB CORP
Entity Type:Organization
Organization Name:NEPHCARE LAB CORP
Other - Org Name:AUTO WORK INJURY REHAB NC INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NEPHTHALI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-218-2089
Mailing Address - Street 1:6820 WESTBOROUGH LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-1356
Mailing Address - Country:US
Mailing Address - Phone:407-218-2089
Mailing Address - Fax:
Practice Address - Street 1:485 S KIRKMAN RD STE 204
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32811-7003
Practice Address - Country:US
Practice Address - Phone:407-218-2089
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-13
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty