Provider Demographics
NPI:1861148272
Name:PATHOLOGY SERVICES PC
Entity type:Organization
Organization Name:PATHOLOGY SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:OSMOND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-285-9548
Mailing Address - Street 1:108 PONDEROSA PARK DR
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-6908
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:108 PONDEROSA PARK DR
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-6908
Practice Address - Country:US
Practice Address - Phone:630-730-6057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PATHOLOGY SERVICES PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-24
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty