Provider Demographics
NPI:1992812473
Name:THERANOSTIX INC
Entity type:Organization
Organization Name:THERANOSTIX INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SATHISH
Authorized Official - Middle Name:
Authorized Official - Last Name:KOTHANDARAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-803-1079
Mailing Address - Street 1:8000 VIRGINIA MANOR RD STE 170
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-4230
Mailing Address - Country:US
Mailing Address - Phone:862-298-5960
Mailing Address - Fax:301-259-5781
Practice Address - Street 1:8000 VIRGINIA MANOR RD
Practice Address - Street 2:SUITE 170
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-4211
Practice Address - Country:US
Practice Address - Phone:862-803-1079
Practice Address - Fax:301-259-5781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory