Provider Demographics
NPI:1104421544
Name:CARE DIAGNOSTIC, LLC
Entity type:Organization
Organization Name:CARE DIAGNOSTIC, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SAHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:FARHAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-789-8534
Mailing Address - Street 1:19855 OUTER DR STE 101
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2022
Mailing Address - Country:US
Mailing Address - Phone:313-789-8534
Mailing Address - Fax:
Practice Address - Street 1:19855 OUTER DR STE 101
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2022
Practice Address - Country:US
Practice Address - Phone:313-789-8534
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-03
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory