Provider Demographics
NPI:1770943391
Name:THE LAUNCH PAD, INC.
Entity type:Organization
Organization Name:THE LAUNCH PAD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-232-5422
Mailing Address - Street 1:PO BOX 16689
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28408-6689
Mailing Address - Country:US
Mailing Address - Phone:910-233-1165
Mailing Address - Fax:910-769-9048
Practice Address - Street 1:3150 MALPASS AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-2625
Practice Address - Country:US
Practice Address - Phone:910-769-9047
Practice Address - Fax:910-769-9048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory