Basic Information
Provider Information
NPI: 1851981146
EntityType: 2
ReplacementNPI:  
OrganizationName: DIMENSIONS HEALTH CORPORATION
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: LAUREL REGIONAL HOSPITAL
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7300 VAN DUSEN RD
Address2:  
City: LAUREL
State: MD
PostalCode: 207079463
CountryCode: US
TelephoneNumber: 3017254300
FaxNumber:  
Practice Location
Address1: 7300 VAN DUSEN RD
Address2:  
City: LAUREL
State: MD
PostalCode: 207079463
CountryCode: US
TelephoneNumber: 3017254300
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/21/2021
LastUpdateDate: 05/21/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: BROZIC
AuthorizedOfficialFirstName: MICHAEL
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CFO
AuthorizedOfficialTelephone: 4109131546
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/21/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
291U00000X  Y LaboratoriesClinical Medical Laboratory 

No ID Information.


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