Provider Demographics
NPI:1225023005
Name:BIOCELLUTIONS, INC
Entity Type:Organization
Organization Name:BIOCELLUTIONS, INC
Other - Org Name:TRANSFUSION MANAGEMENT SERVICES, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR LABORATORY SERVICES
Authorized Official - Prefix:DR
Authorized Official - First Name:BONNI
Authorized Official - Middle Name:J
Authorized Official - Last Name:HAZELTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:901-273-0880
Mailing Address - Street 1:1775 MORIAH WOODS BLVD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-7125
Mailing Address - Country:US
Mailing Address - Phone:901-273-0880
Mailing Address - Fax:901-273-0884
Practice Address - Street 1:1775 MORIAH WOODS BLVD
Practice Address - Street 2:SUITE 8
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-7125
Practice Address - Country:US
Practice Address - Phone:901-273-0880
Practice Address - Fax:901-273-0884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-16
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000002008291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
3403201OtherCOLL OF AMER PATH
TN0000002008OtherTN DEPT OF HEALTH
MS0126553Medicaid
1053225OtherFDA
TN3404106Medicaid
MS0126553Medicaid