Provider Demographics
NPI:1225362924
Name:BUCCANEER CENTER LLC
Entity Type:Organization
Organization Name:BUCCANEER CENTER LLC
Other - Org Name:BUCCANEER MOBILE PHLEBOTOMY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATRINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:PONDER
Authorized Official - Suffix:
Authorized Official - Credentials:PHLEBOTOMIST
Authorized Official - Phone:724-962-0100
Mailing Address - Street 1:426 N MERCER AVE
Mailing Address - Street 2:
Mailing Address - City:SHARPSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16150-2229
Mailing Address - Country:US
Mailing Address - Phone:724-962-0100
Mailing Address - Fax:724-962-0120
Practice Address - Street 1:426 N MERCER AVE
Practice Address - Street 2:
Practice Address - City:SHARPSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16150-2229
Practice Address - Country:US
Practice Address - Phone:724-962-0100
Practice Address - Fax:724-962-0120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-28
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty