BRADSHAW MOUNTAIN DIAGNOSTIC LABORATORY INC (NPI# 1508012253) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508012253 |
| Entity Type | Organization |
| Organization Name | BRADSHAW MOUNTAIN DIAGNOSTIC LABORATORY INC |
| Practice Address |
579 W Wickenburg Way #8 Wickenburg AZ 85390-4300 |
| Mailing Address |
990 Willow Creek Rd Prescott AZ 86301-1640 |
| Practice Telephone | 9286840332 |
| Practice Fax Number | 9286840537 |
| Mailing Telephone | 9287787823 |
| Mailing Fax Number | 9287789419 |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2008-08-13 |
| Authorized Official Name | MR. TOM FELLOWS (PRESIDENT) |
| Authorized Official Telephone | 9287787823 |
| Is Organization Subpart | Y |
| Parent Organization Name | BRADSHAW MOUNTAIN DIAGNOSTIC LABORATORY INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790932820 | Bradshaw Mountain Diagnostic Laboratory Inc | Clinical Medical Laboratory | 7732 East Florentine Rd, Prescott Valley, AZ 86314 | 2008-08-20 |
| 1144476896 | Bradshaw Mountain Diagnostic Laboratory Inc | Clinical Medical Laboratory | 203 S Candy Ln, Suite 115-b2, Cottonwood, AZ 86326-4120 | 2008-08-13 |
| Street Address |
579 W WICKENBURG WAY #8 |
| City | WICKENBURG |
| State | AZ |
| Zip Code | 85390-4300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215559471 | Innovative Dermatology Alliance Az, PC | Dermatology | 390 Bralliar Rd, Wickenburg, AZ 85390 | 2020-05-11 |
| 1982040127 | Lottis & Associates, P.C. | Clinic/Center | 55 E. Yavapai St, Wickenburg, AZ 85390 | 2013-05-15 |
| 1760760250 | New Directions Integrative Wellness Center of Wickenburg, Arizona, Pll | Clinic/Center | 370 Palm Drive, Wickenburg, AZ 85390 | 2011-08-01 |
| 1326278953 | Amy Elizabeth Wasserbauer | Psychologist | One E Apache St, Remuda Ranch Treatment Center, Wickenburg, AZ 85390 | 2009-07-16 |
| 1063653061 | Wallace B Mendelson | Psychiatry & Neurology | 1 E. Apache St., Remuda Ranch, Wickenburg, AZ 85390 | 2009-03-20 |
| 1316195902 | Nichole Elsner | Counselor | 920 S Vulture Mine Rd, Wickenburg, AZ 85390 | 2008-09-08 |
| 1992962310 | Judy Rosittia Zobel | Acupuncturist | 519 Rose Lane, Wickenburg, AZ 85390 | 2008-05-22 |
| 1336361179 | Eduardo Rodolfo Huergo | Psychiatry & Neurology | One East Apache Street, Wickenburg, AZ 85390 | 2007-05-02 |
| 1972625515 | Kari Marie Froelicher | Counselor | 315 Apache Street, Wickenburg, AZ 85390 | 2007-04-04 |
| 1477689933 | Wickenburg Unified School District #9 | Local Education Agency (LEA) | 920 S. Vulture Mine Road, Special Education Office, Wickenburg, AZ 85390 | 2007-02-26 |
| Find all providers in zip 85390 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306096540 | Laboratory Corporation of America | Clinical Medical Laboratory | 811 N Tegner St Ste 109, Wickenburg, AZ 85390-5410 | 2008-09-24 |
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| City | WICKENBURG |
| Zip Code | 85390 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.