Provider Demographics
NPI:1548875818
Name:MYRO ENTERPRISES CORPORATION
Entity type:Organization
Organization Name:MYRO ENTERPRISES CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TIMEA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MAJOROS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-868-9864
Mailing Address - Street 1:1145 2ND ST # 102
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-2292
Mailing Address - Country:US
Mailing Address - Phone:197-386-8986
Mailing Address - Fax:
Practice Address - Street 1:3065 RICHMOND PKWY STE 103
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94806-5718
Practice Address - Country:US
Practice Address - Phone:510-686-4276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-13
Last Update Date:2020-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory