Provider Demographics
NPI:1730249350
Name:PATHWORKS LLC
Entity type:Organization
Organization Name:PATHWORKS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF EXECTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:LEDFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-247-5808
Mailing Address - Street 1:8379 BYERS RD
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-3721
Mailing Address - Country:US
Mailing Address - Phone:937-247-5808
Mailing Address - Fax:937-247-5809
Practice Address - Street 1:8379 BYERS RD
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342
Practice Address - Country:US
Practice Address - Phone:937-247-5808
Practice Address - Fax:937-247-5809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH291U00000X
291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1730249350OtherNPI