Provider Demographics
NPI:1972859171
Name:AMS MEDICAL LABORATORY
Entity Type:Organization
Organization Name:AMS MEDICAL LABORATORY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MEIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-406-0052
Mailing Address - Street 1:9 HOOK POND WAY
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:IL
Mailing Address - Zip Code:62294-1159
Mailing Address - Country:US
Mailing Address - Phone:618-406-0052
Mailing Address - Fax:
Practice Address - Street 1:2900 LEMAY FERRY RD
Practice Address - Street 2:SUITE 205
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63125-3900
Practice Address - Country:US
Practice Address - Phone:314-200-6450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-25
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory