Provider Demographics
NPI: | 1700572450 |
---|---|
Name: | RADCHICK INDUSTRIES LLC |
Entity Type: | Organization |
Organization Name: | RADCHICK INDUSTRIES LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | MANAGER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | STACY |
Authorized Official - Middle Name: | ANTONET |
Authorized Official - Last Name: | RADCLIFFE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | PHLEBOTOMIST |
Authorized Official - Phone: | 760-501-1890 |
Mailing Address - Street 1: | 44489 TOWN CENTER WAY # 1022 |
Mailing Address - Street 2: | |
Mailing Address - City: | PALM DESERT |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 92260-2723 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 760-501-8066 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 44489 TOWN CENTER WAY # 1022 |
Practice Address - Street 2: | |
Practice Address - City: | PALM DESERT |
Practice Address - State: | CA |
Practice Address - Zip Code: | 92260-2723 |
Practice Address - Country: | US |
Practice Address - Phone: | 760-501-8066 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-04-14 |
Last Update Date: | 2023-04-14 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 246RP1900X | Technologists, Technicians & Other Technical Service Providers | Technician, Pathology | Phlebotomy | Group - Single Specialty |