Provider Demographics
NPI:1669095600
Name:AEON TECHNOLOGIES, LLC
Entity type:Organization
Organization Name:AEON TECHNOLOGIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-463-3445
Mailing Address - Street 1:1 TECHNOLOGY DR STE 1600
Mailing Address - Street 2:
Mailing Address - City:FROSTBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21532-2499
Mailing Address - Country:US
Mailing Address - Phone:240-284-2430
Mailing Address - Fax:
Practice Address - Street 1:1 TECHNOLOGY DR STE 1600
Practice Address - Street 2:
Practice Address - City:FROSTBURG
Practice Address - State:MD
Practice Address - Zip Code:21532-2499
Practice Address - Country:US
Practice Address - Phone:240-284-2781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-26
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory