Provider Demographics
NPI:1922016625
Name:RHEUMATOLOGY DIAGNOSTIC LAB
Entity Type:Organization
Organization Name:RHEUMATOLOGY DIAGNOSTIC LAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:R
Authorized Official - Last Name:HEYMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-277-2750
Mailing Address - Street 1:170 W. GERMANTOWN PIKE, NORRITON OFFICE CENTER
Mailing Address - Street 2:SUITE C-2
Mailing Address - City:EAST NORRITON
Mailing Address - State:PA
Mailing Address - Zip Code:19401-1389
Mailing Address - Country:US
Mailing Address - Phone:610-277-2750
Mailing Address - Fax:610-277-9805
Practice Address - Street 1:170 W. GERMANTOWN PIKE, NORRITON OFFICE CENTER
Practice Address - Street 2:SUITE C-2
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19401-1389
Practice Address - Country:US
Practice Address - Phone:610-277-2750
Practice Address - Fax:610-277-9805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA028592291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA301132Medicare ID - Type UnspecifiedDIAGNOSTIC LAB