Provider Demographics
NPI:1205808847
Name:ANATOMIC PATHOLOGY SERVICES INC
Entity type:Organization
Organization Name:ANATOMIC PATHOLOGY SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:KRAMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-550-3000
Mailing Address - Street 1:7111 FAIRWAY DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-4207
Mailing Address - Country:US
Mailing Address - Phone:561-712-6200
Mailing Address - Fax:561-712-7349
Practice Address - Street 1:1145 S UTICA AVE
Practice Address - Street 2:SUITE 367
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-4000
Practice Address - Country:US
Practice Address - Phone:918-749-7964
Practice Address - Fax:918-584-0156
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERIPATH, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-02-07
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK37D0473659291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100748070BMedicaid
AR188902709Medicaid
AR188902709Medicaid
OK=========001OtherBCBS
OK100748070BMedicaid