Provider Demographics
NPI:1245284728
Name:PATHOLOGY ASSOCIATES SERVICES, INC
Entity type:Organization
Organization Name:PATHOLOGY ASSOCIATES SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:RUMBOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-973-2494
Mailing Address - Street 1:800 W HILL ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-5360
Mailing Address - Country:US
Mailing Address - Phone:704-973-5500
Mailing Address - Fax:
Practice Address - Street 1:101 E WT HARRIS BLVD
Practice Address - Street 2:SUITE 1212
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-3485
Practice Address - Country:US
Practice Address - Phone:704-549-8444
Practice Address - Fax:704-549-0559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
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
NC7001155Medicaid
NC2552541Medicare ID - Type Unspecified