Provider Demographics
NPI:1487979142
Name:PHADIA US INC.
Entity type:Organization
Organization Name:PHADIA US INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE & OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:PALMERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-492-1959
Mailing Address - Street 1:4169 COMMERCIAL AVE
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49002-9701
Mailing Address - Country:US
Mailing Address - Phone:800-346-4364
Mailing Address - Fax:877-675-4946
Practice Address - Street 1:4169 COMMERCIAL AVE
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49002-9701
Practice Address - Country:US
Practice Address - Phone:800-346-4364
Practice Address - Fax:877-675-4946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI23D1088923291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory