Provider Demographics
NPI:1760136105
Name:MEDICAL TESTERS, INC
Entity Type:Organization
Organization Name:MEDICAL TESTERS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:BASHAH
Authorized Official - Middle Name:T
Authorized Official - Last Name:GAINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-216-7352
Mailing Address - Street 1:137 MAGNAVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-3039
Mailing Address - Country:US
Mailing Address - Phone:321-216-7352
Mailing Address - Fax:
Practice Address - Street 1:137 MAGNAVIEW DR
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-3039
Practice Address - Country:US
Practice Address - Phone:321-216-7352
Practice Address - Fax:404-393-0703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-04
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No291U00000XLaboratoriesClinical Medical LaboratoryGroup - Multi-Specialty