Provider Demographics
NPI:1982940862
Name:MEDCOMP SCIENCES LLC
Entity type:Organization
Organization Name:MEDCOMP SCIENCES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:T
Authorized Official - Last Name:BEASLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-570-8486
Mailing Address - Street 1:PO BOX 800
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-0800
Mailing Address - Country:US
Mailing Address - Phone:225-570-8486
Mailing Address - Fax:225-570-8487
Practice Address - Street 1:20203 MACHOST RD
Practice Address - Street 2:
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791-7235
Practice Address - Country:US
Practice Address - Phone:225-570-8486
Practice Address - Fax:225-570-8487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-20
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA19D2050143OtherCLIA