Provider Demographics
NPI:1851089676
Name:APPALACHIAN CLINICAL SERVICES
Entity Type:Organization
Organization Name:APPALACHIAN CLINICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FREDRICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-628-0900
Mailing Address - Street 1:1388 SAND HILL RD STE 10
Mailing Address - Street 2:
Mailing Address - City:CANDLER
Mailing Address - State:NC
Mailing Address - Zip Code:28715-8937
Mailing Address - Country:US
Mailing Address - Phone:828-429-4214
Mailing Address - Fax:828-492-4240
Practice Address - Street 1:1388 SAND HILL RD STE 10
Practice Address - Street 2:
Practice Address - City:CANDLER
Practice Address - State:NC
Practice Address - Zip Code:28715-8937
Practice Address - Country:US
Practice Address - Phone:828-492-4214
Practice Address - Fax:828-492-4240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-28
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory