Provider Demographics
NPI:1073788410
Name:L & L MEDICAL SERVICES, LLC
Entity Type:Organization
Organization Name:L & L MEDICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHLEBOTOMIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:I
Authorized Official - Last Name:YBARRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-305-4387
Mailing Address - Street 1:9496 S VIA BANDERA
Mailing Address - Street 2:
Mailing Address - City:VAIL
Mailing Address - State:AZ
Mailing Address - Zip Code:85641-2159
Mailing Address - Country:US
Mailing Address - Phone:520-631-3750
Mailing Address - Fax:520-305-4387
Practice Address - Street 1:9496 S VIA BANDERA
Practice Address - Street 2:
Practice Address - City:VAIL
Practice Address - State:AZ
Practice Address - Zip Code:85641-2159
Practice Address - Country:US
Practice Address - Phone:520-631-3750
Practice Address - Fax:520-305-4387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171W00000X
AZ03D2012178291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No171W00000XOther Service ProvidersContractorGroup - Single Specialty