Basic Information
Provider Information
NPI: 1467780569
EntityType: 2
ReplacementNPI:  
OrganizationName: QUEST DIAGNOSTICS INCORPORATED
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1001 ADAMS AVE MRGOV
Address2: 2ND FLOOR
City: NORRISTOWN
State: PA
PostalCode: 194032429
CountryCode: US
TelephoneNumber: 4846767000
FaxNumber: 4846765309
Practice Location
Address1: 1200 COLLEGEVILLE RD
Address2:  
City: COLLEGEVILLE
State: PA
PostalCode: 194261049
CountryCode: US
TelephoneNumber: 8008777484
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/01/2009
LastUpdateDate: 09/21/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: CARTIER
AuthorizedOfficialFirstName: GERALD
AuthorizedOfficialMiddleName: SCOTT
AuthorizedOfficialTitleorPosition: VP OF REVENUE SERVICES
AuthorizedOfficialTelephone: 4846767000
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
291U00000X  Y LaboratoriesClinical Medical Laboratory 

No ID Information.


Home