Provider Demographics
NPI:1710985353
Name:METABOLIC SOLUTIONS LLC
Entity type:Organization
Organization Name:METABOLIC SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AO
Authorized Official - Prefix:
Authorized Official - First Name:ADNAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FAKHOURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-598-6960
Mailing Address - Street 1:460 AMHERST ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03063-1220
Mailing Address - Country:US
Mailing Address - Phone:603-598-6960
Mailing Address - Fax:603-598-6973
Practice Address - Street 1:460 AMHERST ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063-1220
Practice Address - Country:US
Practice Address - Phone:603-598-6960
Practice Address - Fax:603-598-6973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-08
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY30D0970292291U00000X
NH02731291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR148922709Medicaid
MI164498454Medicaid
AZ89450201Medicaid
OH2386565Medicaid
ME151870000Medicaid
NH30802448Medicaid
SCL00181Medicaid
NY02517655Medicaid
IN200454380AMedicaid
NC7001225Medicaid
ID806879100Medicaid
GA831608202AMedicaid
AL009931755Medicaid
CT003119220Medicaid
OK200050790AMedicaid
LA1164119Medicaid
TX157047502Medicaid
AKLB460NHMedicaid