Provider Demographics
NPI:1942203443
Name:ASSOCIATED PATHOLOGISTS OF HUNTINGTON, INC.
Entity Type:Organization
Organization Name:ASSOCIATED PATHOLOGISTS OF HUNTINGTON, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-526-1081
Mailing Address - Street 1:PO BOX 130
Mailing Address - Street 2:
Mailing Address - City:MAXWELTON
Mailing Address - State:WV
Mailing Address - Zip Code:24957-0130
Mailing Address - Country:US
Mailing Address - Phone:304-645-4090
Mailing Address - Fax:304-645-4702
Practice Address - Street 1:2900 1ST AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25702-1241
Practice Address - Country:US
Practice Address - Phone:304-526-1081
Practice Address - Fax:304-526-1538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0011492000Medicaid
WV0011492000Medicaid
WV9291191Medicare ID - Type Unspecified
KY5128Medicare ID - Type Unspecified