IDESTA MEDICAL INC NPI 1063185015

NPI Information

NPI: 1063185015
Provider Name: IDESTA MEDICAL INC
Classification: Technician, Pathology - 246RP1900X
Entity Type: Organization

Specialization: Phlebotomy

Address:
4827 OLD NATIONAL HWY UNIT 2032
COLLEGE PARK, GA
ZIP 30337
Phone: (239) 895-7910
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IDESTA MEDICAL INC is a phlebotomy technician pathology in College Park, GA. IDESTA MEDICAL INC NPI is 1063185015. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4827 OLD NATIONAL HWY UNIT 2032
COLLEGE PARK, GA
ZIP 30337-234
Phone: (239) 895-7910
Fax: (866) 984-3729

The provider's authorized official is Idesta Ralph .
The authorized official title is Owner and has the following contact phone number (239) 895-7910.

The enumeration date for this NPI number is 7/27/2021 and was last updated on 7/27/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207ZB0001X	Pathology	Blood Banking & Transfusion Medicine			No
2	246RP1900X	Technician, Pathology	Phlebotomy			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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