Provider Demographics
NPI:1881747590
Name:UNITED PATHOLOGY INC.
Entity type:Organization
Organization Name:UNITED PATHOLOGY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-459-1984
Mailing Address - Street 1:75 COLONIA DE SALUD
Mailing Address - Street 2:SUITE 200D
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-2487
Mailing Address - Country:US
Mailing Address - Phone:520-459-1984
Mailing Address - Fax:520-452-1011
Practice Address - Street 1:75 COLONIA DE SALUD
Practice Address - Street 2:SUITE 200D
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-2487
Practice Address - Country:US
Practice Address - Phone:520-459-1984
Practice Address - Fax:520-452-1011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ220004044OtherRAILROAD MEDICARE PIN
AZ220004044OtherRAILROAD MEDICARE PIN
AZ220004044OtherRAILROAD MEDICARE PIN