Provider Demographics
NPI:1992292304
Name:BIO-SERV CORPORATION
Entity type:Organization
Organization Name:BIO-SERV CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-843-7673
Mailing Address - Street 1:2620 CENTENNIAL RD STE F
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43617-1800
Mailing Address - Country:US
Mailing Address - Phone:419-843-7673
Mailing Address - Fax:419-843-5132
Practice Address - Street 1:2620 CENTENNIAL RD STE F
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-1800
Practice Address - Country:US
Practice Address - Phone:419-843-7673
Practice Address - Fax:419-843-5132
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BIO-SERV CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-20
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========Medicaid