Provider Demographics
NPI:1386761294
Name:EMPIRE SCANNING SERVICES, INC
Entity type:Organization
Organization Name:EMPIRE SCANNING SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:BOTH
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:888-401-9998
Mailing Address - Street 1:PO BOX 270
Mailing Address - Street 2:
Mailing Address - City:MALVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11565-0270
Mailing Address - Country:US
Mailing Address - Phone:800-559-3413
Mailing Address - Fax:
Practice Address - Street 1:789 DEER PARK AVE
Practice Address - Street 2:
Practice Address - City:NORTH BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11703-4311
Practice Address - Country:US
Practice Address - Phone:888-401-9998
Practice Address - Fax:800-559-3413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes293D00000XLaboratoriesPhysiological Laboratory
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY97Z301Medicare PIN