Organization
GREENSBORO PATHOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL C. GRATTENDICK (VICE PRESIDENT)
(561) 626-5512
Entity
Organization
Contact information
Practice address
706 GREEN VALLEY RD, SUITE 104, GREENSBORO, NC 27408-7038
(336) 271-4930
(336) 271-8466
Mailing address
11025 RCA CENTER DRIVE, SUITE 300, PALM BEACH GARDENS, FL 33410-4269
(561) 626-5512
(561) 626-4530
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CC3781
RAILROAD MEDICARE
—
Enumeration date
02/27/2006
Last updated
02/17/2015
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