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Contact Information

PORTABLE MEDICAL DIAGNOSTICS LLC
9047 HOME AVE
IRVINGTON, AL36544-2855
 Phone: 251-272-1080
 Fax: 251-272-1080
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physiological Laboratory, (Independent Physiological Lab)

293D00000X 47 Independent Diagnostic Testing Facility (IDTF)
Indicates primary specialty

NPI Profile & details for PORTABLE MEDICAL DIAGNOSTICS LLC

NPI Number 1730425547
LBN Legal business name PORTABLE MEDICAL DIAGNOSTICS LLC
Authorized official DOUGLAS BROWN - (MANAGING MEMBER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/26/2012
Last updated 07/21/2014 - About 12 years ago
Identifiers
AL Other 9074 STATE BOARD OF HEALTH IPL LICENSE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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