Provider Demographics
NPI:1669773347
Name:SYNERGY DIAGNOSTICS LLC
Entity type:Organization
Organization Name:SYNERGY DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:REGINALD
Authorized Official - Middle Name:DEBS
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-330-3328
Mailing Address - Street 1:PO BOX 3223
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93278-3223
Mailing Address - Country:US
Mailing Address - Phone:800-330-3328
Mailing Address - Fax:800-280-4200
Practice Address - Street 1:1920 W PRINCETON AVE STE A
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-4400
Practice Address - Country:US
Practice Address - Phone:800-330-3328
Practice Address - Fax:800-280-4200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-10
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies