Provider Demographics
NPI:1215536214
Name:WEST MOBILE PHLEBOTOMY CORPORATION
Entity Type:Organization
Organization Name:WEST MOBILE PHLEBOTOMY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, DIRECTOR OF CLINICAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:321-806-9009
Mailing Address - Street 1:807 GLENCOVE AVE NW
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32907-7036
Mailing Address - Country:US
Mailing Address - Phone:321-272-0791
Mailing Address - Fax:
Practice Address - Street 1:807 GLENCOVE AVE NW
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32907-7036
Practice Address - Country:US
Practice Address - Phone:321-272-0791
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-21
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty