Provider Demographics
NPI:1205440435
Name:TOTH ENTERPRISES, II PA
Entity type:Organization
Organization Name:TOTH ENTERPRISES, II PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:HOLLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-462-3627
Mailing Address - Street 1:4303 VICTORY DRIVE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-7507
Mailing Address - Country:US
Mailing Address - Phone:512-462-3627
Mailing Address - Fax:512-462-2829
Practice Address - Street 1:2110 W BEN WHITE BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7507
Practice Address - Country:US
Practice Address - Phone:512-462-3627
Practice Address - Fax:512-462-2898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-04
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory