Provider Demographics
NPI:1386228294
Name:MASSEY MOBILE PHLEBOTOMY SERVICE LLC
Entity Type:Organization
Organization Name:MASSEY MOBILE PHLEBOTOMY SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SABERRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MASSEY-HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-281-9482
Mailing Address - Street 1:833 ELSWORTH PL
Mailing Address - Street 2:
Mailing Address - City:FERGUSON
Mailing Address - State:MO
Mailing Address - Zip Code:63135-3127
Mailing Address - Country:US
Mailing Address - Phone:314-250-7206
Mailing Address - Fax:
Practice Address - Street 1:6439 PLYMOUTH AVE STE 110
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63133-1940
Practice Address - Country:US
Practice Address - Phone:314-281-9482
Practice Address - Fax:314-300-4055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-06
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty