Provider Demographics
NPI:1659615730
Name:PREMIER ANALYTICAL SERVICES
Entity type:Organization
Organization Name:PREMIER ANALYTICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:S
Authorized Official - Last Name:TAUB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-442-9805
Mailing Address - Street 1:3535 RANDOLPH RD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-1086
Mailing Address - Country:US
Mailing Address - Phone:704-442-9805
Mailing Address - Fax:704-405-0868
Practice Address - Street 1:3535 RANDOLPH RD
Practice Address - Street 2:SUITE 209
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-1086
Practice Address - Country:US
Practice Address - Phone:704-442-9805
Practice Address - Fax:704-405-0868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC34D2043658291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory