Provider Demographics
NPI:1093118192
Name:PHLEBOTOMY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:PHLEBOTOMY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LAB MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LATORYA
Authorized Official - Middle Name:E
Authorized Official - Last Name:BARBER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:513-910-2498
Mailing Address - Street 1:10019 DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40272-5916
Mailing Address - Country:US
Mailing Address - Phone:502-937-6010
Mailing Address - Fax:
Practice Address - Street 1:10019 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40272-5916
Practice Address - Country:US
Practice Address - Phone:502-937-6010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-02
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY18D2080283291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory