Basic Information
| Provider Information | |||||||||
| NPI: | 1194803395 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PATHOLOGY SERVICE ASSOCIATES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1362 CELEBRATION BLVD | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295015495 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8008325270 | ||||||||
| FaxNumber: | 8436644322 | ||||||||
| Practice Location | |||||||||
| Address1: | 1362 CELEBRATION BLVD | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295015495 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8008325270 | ||||||||
| FaxNumber: | 8436644322 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2006 | ||||||||
| LastUpdateDate: | 05/01/2012 | ||||||||
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| AuthorizedOfficialLastName: | SALTZMAN | ||||||||
| AuthorizedOfficialFirstName: | BAMA | ||||||||
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| AuthorizedOfficialTitleorPosition: | SENIOR VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8008325270 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZB0001X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pathology | Blood Banking & Transfusion Medicine | 207ZC0500X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pathology | Cytopathology | 207ZD0900X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pathology | Dermatopathology | 207ZH0000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pathology | Hematology | 207ZI0100X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pathology | Immunopathology | 207ZP0102X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
No ID Information.