Provider Demographics
NPI:1720006786
Name:QUEST DIAGNOSTICS INCORPORATED
Entity Type:Organization
Organization Name:QUEST DIAGNOSTICS INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF REVENUE SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:CARTIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-676-7000
Mailing Address - Street 1:1001 ADAMS AVE
Mailing Address - Street 2:MRGOV 2ND FLOOR
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19403-2429
Mailing Address - Country:US
Mailing Address - Phone:484-676-7000
Mailing Address - Fax:484-676-5309
Practice Address - Street 1:50 MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:RI
Practice Address - Zip Code:02840-3587
Practice Address - Country:US
Practice Address - Phone:401-847-2290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI41D0082482291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA228096Medicare PIN