Provider Demographics
NPI: | 1679996847 |
---|---|
Name: | DISCOVERY CLINICAL RESEARCH, INC. |
Entity type: | Organization |
Organization Name: | DISCOVERY CLINICAL RESEARCH, INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | VICE PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JILLIAN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MARCUS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 954-838-2766 |
Mailing Address - Street 1: | 1613 HARRISON PKWY |
Mailing Address - Street 2: | BUILDING C, SUITE 200 |
Mailing Address - City: | SUNRISE |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33323-2896 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 954-838-2729 |
Mailing Address - Fax: | 954-851-1756 |
Practice Address - Street 1: | 1613 HARRISON PKWY |
Practice Address - Street 2: | BUILDING C, SUITE 200 |
Practice Address - City: | SUNRISE |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33323-2896 |
Practice Address - Country: | US |
Practice Address - Phone: | 954-838-2729 |
Practice Address - Fax: | 954-851-1756 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2014-01-24 |
Last Update Date: | 2014-01-24 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 1744R1102X | Other Service Providers | Specialist | Research Study | Group - Multi-Specialty |