Provider Demographics
NPI:1700855442
Name:ACCUPATH LABORATORY SERVICES INC
Entity Type:Organization
Organization Name:ACCUPATH LABORATORY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:HENTHORNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-375-3786
Mailing Address - Street 1:30701 LORAIN RD STE A
Mailing Address - Street 2:
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-6325
Mailing Address - Country:US
Mailing Address - Phone:440-274-5000
Mailing Address - Fax:440-716-8608
Practice Address - Street 1:525 E MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1619
Practice Address - Country:US
Practice Address - Phone:330-375-3786
Practice Address - Fax:330-375-4874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-15
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000220095OtherANTHEM BLUE CROSS BLUE SHIELD
OH2193273Medicaid
3500199OtherUNITED HEALTH CARE
OH=========002OtherMEDICAL MUTUAL OF OHIO
000000220095OtherANTHEM BLUE CROSS BLUE SHIELD
OH2193273Medicaid
P00330314Medicare PIN