Provider Demographics
NPI:1538020482
Name:PROMINENT TOXICOLOGY SCREENINGS LLC
Entity type:Organization
Organization Name:PROMINENT TOXICOLOGY SCREENINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEJONE
Authorized Official - Middle Name:
Authorized Official - Last Name:DENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-441-0653
Mailing Address - Street 1:2030 REEVES ST
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74401-4018
Mailing Address - Country:US
Mailing Address - Phone:918-351-0203
Mailing Address - Fax:918-393-0018
Practice Address - Street 1:2030 REEVES ST
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74401-4018
Practice Address - Country:US
Practice Address - Phone:918-351-0203
Practice Address - Fax:918-393-0018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-20
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory