Provider Demographics
NPI:1003592528
Name:VAMP MOBILE PHLEBOTOMY SERVICE LLC
Entity Type:Organization
Organization Name:VAMP MOBILE PHLEBOTOMY SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KAYTRELL
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-341-1335
Mailing Address - Street 1:119 S MAIN ST UNIT 37
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-2757
Mailing Address - Country:US
Mailing Address - Phone:800-341-1335
Mailing Address - Fax:800-390-9151
Practice Address - Street 1:6845 BELLAWOOD DR
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:NC
Practice Address - Zip Code:27370-7542
Practice Address - Country:US
Practice Address - Phone:800-341-1335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory