Provider Demographics
NPI:1598728107
Name:HARRIS HISTOLOGY RELIEF SERVICES INC
Entity type:Organization
Organization Name:HARRIS HISTOLOGY RELIEF SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:TROYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-830-6866
Mailing Address - Street 1:2025 EASTGATE DR
Mailing Address - Street 2:SUITE F
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-4154
Mailing Address - Country:US
Mailing Address - Phone:252-830-6866
Mailing Address - Fax:252-830-0032
Practice Address - Street 1:2025 EASTGATE DR
Practice Address - Street 2:SUITE F
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-4154
Practice Address - Country:US
Practice Address - Phone:252-830-6866
Practice Address - Fax:252-830-0032
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROVIA DIAGNOSTICS INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-07
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7001138Medicaid
NC34D0882748OtherCLIA
NC690007364OtherRAILROAD MEDICARE
NC01952OtherBCBS
NC690007364OtherRAILROAD MEDICARE
NC34D0882748OtherCLIA