Organization
GENETIC ASSAYS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE A MAMMARELLI (PRESIDENT / CEO)
(615) 781-0709
Entity
Organization
Contact information
Practice address
4711 TROUSDALE DR, SUITE 209, NASHVILLE, TN 37220-1321
(615) 781-0709
(615) 781-0766
Mailing address
4711 TROUSDALE DR, SUITE 209, NASHVILLE, TN 37220-1321
(615) 781-0709
(615) 781-0766
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
0000003268
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202182
BLUE CROSS BLUE SHIELD TN
TN
01
—
1710195235
MEDICAL DIRECTOR
TN
05
—
37000866
—
KY
05
—
690000007
—
AL
Enumeration date
09/20/2006
Last updated
11/19/2024
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