Provider Demographics
NPI:1508453739
Name:NCGM INC
Entity Type:Organization
Organization Name:NCGM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAILESH
Authorized Official - Middle Name:
Authorized Official - Last Name:VYAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-267-4688
Mailing Address - Street 1:9760 HOLLY SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27539-7620
Mailing Address - Country:US
Mailing Address - Phone:919-267-4688
Mailing Address - Fax:
Practice Address - Street 1:9760 HOLLY SPRINGS RD
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27539-7620
Practice Address - Country:US
Practice Address - Phone:919-267-4688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-22
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory