Provider Demographics
NPI:1043629330
Name:BLESSED HANDS PHLEBOTOMY
Entity Type:Organization
Organization Name:BLESSED HANDS PHLEBOTOMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHLEBOTOMIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CHENNETHA
Authorized Official - Middle Name:
Authorized Official - Last Name:EPHRIAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-551-5664
Mailing Address - Street 1:3809 CRUSADER DR
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-9003
Mailing Address - Country:US
Mailing Address - Phone:910-551-5664
Mailing Address - Fax:
Practice Address - Street 1:3809 CRUSADER DR
Practice Address - Street 2:
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348-9003
Practice Address - Country:US
Practice Address - Phone:910-551-5664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-12
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC630331140001246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty