Organization
NEXUS LAB 2.0 LLC
Active
Parent organization
PREMIERTOX 2.0 INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
PREMIERTOX 2.0 INC.
Authorized official
ROBERT L. BERTRAM D.O. (MANAGING MEMBER)
(270) 866-8881
Entity
Organization
Contact information
Practice address
400 N DIXIE HWY, CAVE CITY, KY 42127-9546
(270) 792-3902
(270) 773-3738
Mailing address
PO BOX 1038, FRANKFORT, KY 40602-1038
(502) 226-3858
(502) 223-9829
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
07/19/2011
Last updated
07/19/2011
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