Provider Demographics
NPI:1972320703
Name:BISHOP, SANTANNA CAROL (CEO)
Entity type:Individual
Prefix:MISS
First Name:SANTANNA
Middle Name:CAROL
Last Name:BISHOP
Suffix:
Gender:F
Credentials:CEO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2705 COLLINGWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43610-1442
Mailing Address - Country:US
Mailing Address - Phone:419-378-5891
Mailing Address - Fax:
Practice Address - Street 1:2255 W LASKEY RD STE C1
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43613-3563
Practice Address - Country:US
Practice Address - Phone:419-378-5893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician