Provider Demographics
NPI:1790470763
Name:HEALTHTRACKRX OF CALIFORNIA, LLC
Entity Type:Organization
Organization Name:HEALTHTRACKRX OF CALIFORNIA, LLC
Other - Org Name:HEALTHTRACKRX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKENZIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-444-7701
Mailing Address - Street 1:1500 INTERSTATE 35 W
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76207-2402
Mailing Address - Country:US
Mailing Address - Phone:866-287-3218
Mailing Address - Fax:214-975-2717
Practice Address - Street 1:14743 VENTURA BLVD STE 101
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-3641
Practice Address - Country:US
Practice Address - Phone:866-287-3218
Practice Address - Fax:214-975-2717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-06
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory