Provider Demographics
NPI:1912662867
Name:ERSO DIAGNOSTICS LLC
Entity type:Organization
Organization Name:ERSO DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED REP
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:H
Authorized Official - Last Name:BLOCKSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-952-3776
Mailing Address - Street 1:417 E BALTIMORE ST STE F
Mailing Address - Street 2:
Mailing Address - City:TANEYTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21787-2339
Mailing Address - Country:US
Mailing Address - Phone:443-952-3776
Mailing Address - Fax:443-952-3776
Practice Address - Street 1:417 E BALTIMORE ST STE F
Practice Address - Street 2:
Practice Address - City:TANEYTOWN
Practice Address - State:MD
Practice Address - Zip Code:21787-2339
Practice Address - Country:US
Practice Address - Phone:443-952-3776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-05
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory