Provider Demographics
NPI:1255633996
Name:FORTIER SUBSTANCE ABUSE TESTING, INC.
Entity type:Organization
Organization Name:FORTIER SUBSTANCE ABUSE TESTING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NIKKI
Authorized Official - Middle Name:
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-883-6962
Mailing Address - Street 1:PO BOX 140088
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-0088
Mailing Address - Country:US
Mailing Address - Phone:615-883-6962
Mailing Address - Fax:615-829-5885
Practice Address - Street 1:2267 JACKSON DOWNS BLVD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-2300
Practice Address - Country:US
Practice Address - Phone:615-883-6962
Practice Address - Fax:615-829-5885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory