Provider Demographics
NPI:1659956944
Name:CARDINAL PATHOLOGY PC
Entity Type:Organization
Organization Name:CARDINAL PATHOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MACAULAY
Authorized Official - Suffix:
Authorized Official - Credentials:DR
Authorized Official - Phone:970-945-7564
Mailing Address - Street 1:PO BOX 2725
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81602-2725
Mailing Address - Country:US
Mailing Address - Phone:970-945-7564
Mailing Address - Fax:855-593-7091
Practice Address - Street 1:320 BEARD CREEK RD
Practice Address - Street 2:VAIL VALLEY SURGICAL CENTER
Practice Address - City:EDWARDS
Practice Address - State:CO
Practice Address - Zip Code:81632-6426
Practice Address - Country:US
Practice Address - Phone:970-945-7564
Practice Address - Fax:855-593-7091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-17
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Multi-Specialty