Provider Demographics
NPI:1023715885
Name:STARTING POINT OF KENTUCKY, PSC
Entity type:Organization
Organization Name:STARTING POINT OF KENTUCKY, PSC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUPERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCORMAC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-527-3145
Mailing Address - Street 1:PO BOX 749057
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-9057
Mailing Address - Country:US
Mailing Address - Phone:800-805-6989
Mailing Address - Fax:
Practice Address - Street 1:12610 TOWNEPARK WAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-2068
Practice Address - Country:US
Practice Address - Phone:800-805-6989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STARTING POINT OF KENTUCKY, PSC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-13
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY18D2154229OtherCLIA