PREMIERTOX 2.0 INC. (NPI# 1619265071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619265071 |
| Entity Type | Organization |
| Organization Name | PREMIERTOX 2.0 INC. |
| Other Organization Name | PREMIERTOX LABORATORY |
| Practice Address |
1814 Cumberland Ave Middlesboro KY 40965-1229 |
| Mailing Address |
Po Box 638995 Cincinnati OH 45263-8995 |
| Practice Telephone | 8774128330 |
| Practice Fax Number | 8449820300 |
| Mailing Telephone | (877) 412-8330 |
| Mailing Fax Number | 8449820300 |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2017-07-29 |
| Authorized Official Name | MR. STEVEN E KLIPP (PRESIDENT) |
| Authorized Official Telephone | 8774128330 |
| Is Organization Subpart | Y |
| Parent Organization Name | PREMIERTOX 2.0 INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 291U00000X | Clinical Medical Laboratory | Laboratories | ||
| Y | 291U00000X | Clinical Medical Laboratory | 200322 | KY | Laboratories |
| Other Name | Type Code |
|---|---|
| Premiertox Laboratory | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649671827 | Premiertox 2.0 Inc. | Clinical Medical Laboratory | 150 W Bear Track Rd, Campbellsville, KY 42718-8709 | 2014-09-08 |
| 1578908869 | Premiertox 2.0 Inc. | Clinical Medical Laboratory | 7333 Barlite Blvd, Suite 260, San Antonio, TX 78224-1320 | 2013-05-01 |
| 1023306347 | Premiertox 2.0 Inc. | Clinical Medical Laboratory | 2431 Lakeway Drive, Suite 17a-1, Russell Springs, KY 42642-4510 | 2011-07-20 |
| Street Address |
1814 CUMBERLAND AVE |
| City | MIDDLESBORO |
| State | KY |
| Zip Code | 40965-1229 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376558148 | Shahzad Shahmalak | Psychiatry & Neurology | 1814 Cumberland Ave, Middlesboro, KY 40965-1229 | 2006-07-30 |
| 1497238398 | Appalachian Licensed Psychiatric Services, Pllc | Psychiatry & Neurology | 1814 Cumberland Ave, Middlesboro, KY 40965-1229 | 2018-09-07 |
| 1023538758 | Blue Mountain Medical Clinic, Pllc | Family Medicine | 1814 Cumberland Ave, Middlesboro, KY 40965 | 2017-06-23 |
| 1477974558 | Larra Williams | Social Worker | 1814 Cumberland Ave, Middlesboro, KY 40965-1229 | 2013-12-17 |
| 1629101068 | Rehabilitation Drug Services Inc | Psychiatry & Neurology | 1814 Cumberland Ave, Middlesboro, KY 40965-1229 | 2007-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396387064 | Christopher Bruce Ellison | Social Worker | 809 19th Street, Middlesboro, KY 40965 | 2019-10-14 |
| 1982255030 | Johnny Wade Nantz II | Case Manager/Care Coordinator | 809 N 19th St, Middlesboro, KY 40965 | 2019-09-20 |
| 1558827774 | August Pediatrics, LLC | Pediatrics | 123 N 19th St Ste 302, Middlesboro, KY 40965 | 2019-02-12 |
| 1558843227 | Bethany Lauren Wade | Case Manager/Care Coordinator | 19th St, 809, Middlesboro, KY 40965 | 2018-08-30 |
| 1124521505 | Sonya Joyce Mcneil | Speech-Language Pathologist | Kidabilities Pediatric Therapy Center, 2801 Highway 25e, Suite 98, Middlesboro, KY 40965 | 2018-03-13 |
| 1518499862 | Vikki Lynn Johnson | Case Manager/Care Coordinator | 809 North 19th Street, Middlesboro, KY 40965 | 2017-03-28 |
| 1184164287 | Wilson Jeffrey | Occupational Therapist | Address: 235 New Wilson Lane, Middlesboro, KY 40965 | 2017-03-08 |
| 1447797444 | Lesha Loretta Williams | Physician Assistant | 2004 Cumberland Ave Ste 100, Middlesboro, KY 40965 | 2017-01-27 |
| 1619423910 | Audra Anissa Hall | Physical Therapist | 108 Turner Lane, Middlesboro, KY 40965 | 2016-08-28 |
| 1700332061 | Tammy Mclain | Counselor | Selfrefind 809 North 19th Street, Middlesboro, KY 40965 | 2016-08-28 |
| Find all providers in zip 40965 | ||||
| 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 |
|---|---|---|---|---|
| 1578873493 | Nexus Lab, Inc. | Clinical Medical Laboratory | 1814 Cumberland Avenue, Middlesboro Manor Shopping Center, Middlesboro, KY 40965 | 2010-10-13 |
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|---|---|---|---|---|
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| 1215544549 | Pearl Diagnostic Laboratories, LLC | Clinical Medical Laboratory | 2202 Buechel Ave Ste 105d, Louisville, KY 40218-2672 | 2020-09-30 |
| 1114545688 | Sts Lab 2 LLC | Clinical Medical Laboratory | 3521 Point Pleasant Rd, Hebron, KY 41048-9713 | 2020-07-10 |
| 1346870979 | Sterling Toxicology LLC | Clinical Medical Laboratory | 125 Foxglove Dr Ste C, Mt Sterling, KY 40353-9735 | 2020-01-23 |
| 1659927333 | Hc Systems, LLC | Clinical Medical Laboratory | 1400 Browns Ln Ste C, Louisville, KY 40207-4696 | 2019-08-17 |
| 1497223473 | X-gene Molecular Laboratories | Clinical Medical Laboratory | 989 Governors Ln Ste 140, Lexington, KY 40513-1174 | 2018-11-07 |
| 1861975062 | Eurofins Clinical Molecular Testing Services LLC | Clinical Medical Laboratory | 12701 Plantside Dr, Louisville, KY 40299-6388 | 2018-09-13 |
| 1497247894 | My Turning Point, LLC | Clinical Medical Laboratory | 235 Stokely Rd, Cynthiana, KY 41031-2104 | 2018-05-31 |
| 1114435492 | Dx Solutions, LLC | Clinical Medical Laboratory | 110 Dewey Dr Ste A, Nicholasville, KY 40356-7124 | 2018-01-20 |
| Find all providers with the same taxonomy | ||||
| City | MIDDLESBORO |
| Zip Code | 40965 |
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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.