Provider Demographics
NPI:1720960156
Name:PRESTIGE MEDICAL & TESTING SOLUTIONS
Entity type:Organization
Organization Name:PRESTIGE MEDICAL & TESTING SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOMINIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:943-263-8160
Mailing Address - Street 1:1800 PHOENIX BLVD STE 128-12
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-5593
Mailing Address - Country:US
Mailing Address - Phone:943-263-8160
Mailing Address - Fax:678-661-8882
Practice Address - Street 1:1800 PHOENIX BLVD STE 128-12
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349-5593
Practice Address - Country:US
Practice Address - Phone:943-263-8160
Practice Address - Fax:678-661-8882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty