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Organization
PIONEER PATHOLOGY, S.C.
Active
Organization
PIONEER PATHOLOGY, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT NASH M.D. (PRESIDENT)
(877) 852-4669
Entity
Organization
Contact information
Practice address
800 E LOCUST ST, OLNEY, IL 62450-2553
(877) 852-4669
Mailing address
PO BOX 10140, PEORIA, IL 61612-0140
(877) 852-4669
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08032002
BLUE CROSS BLUE SHIELD
IL
Enumeration date
07/06/2006
Last updated
05/12/2011
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