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Organization

PHARMASAN LABS INC

Active
Other names
NeuroScience Inc
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GOTTFRIED KELLERMANN PHD (OWNER PRESIDENT)
(715) 294-2144
Entity
Organization

Contact information

Practice address
375 280TH ST, OSCEOLA, WI 54020-4120
(715) 294-2144
(715) 294-2006
Mailing address
375 280TH ST, OSCEOLA, WI 54020-4120
(715) 294-2144
(715) 294-2006

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
30F23PH
BCBS PROVIDER NUMBER
MN
01
34-0031
MEDICA PROVIDER NUMBER
WI
01
7751240
AETNA
WI
Enumeration date
10/03/2006
Last updated
08/22/2020
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