Basic Information
| Provider Information | |||||||||
| NPI: | 1346486644 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AMERIDRUG LABORATORIES INC | ||||||||
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| OtherOrganizationName: | AMERIDRUG | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 7446 | ||||||||
| Address2: | |||||||||
| City: | LOVELAND | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805370446 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9706351805 | ||||||||
| FaxNumber: | 9706670847 | ||||||||
| Practice Location | |||||||||
| Address1: | 6748 N FRANKLIN AVE | ||||||||
| Address2: | |||||||||
| City: | LOVELAND | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805381178 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9706351805 | ||||||||
| FaxNumber: | 9706670847 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/17/2008 | ||||||||
| LastUpdateDate: | 04/09/2013 | ||||||||
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| AuthorizedOfficialLastName: | HUFF | ||||||||
| AuthorizedOfficialFirstName: | BLANE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO/ FOUNDER | ||||||||
| AuthorizedOfficialTelephone: | 9703771722 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 291U00000X | CO | Y | Laboratories | Clinical Medical Laboratory |
No ID Information.