Provider Demographics
NPI:1396230074
Name:MOBILE STICK
Entity Type:Organization
Organization Name:MOBILE STICK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED PHLEBOTOMIST/PCT
Authorized Official - Prefix:
Authorized Official - First Name:LETARSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-417-9568
Mailing Address - Street 1:PO BOX 1033
Mailing Address - Street 2:
Mailing Address - City:RINCON
Mailing Address - State:GA
Mailing Address - Zip Code:31326-1033
Mailing Address - Country:US
Mailing Address - Phone:912-441-8935
Mailing Address - Fax:
Practice Address - Street 1:23 RISTONA DR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31419-6220
Practice Address - Country:US
Practice Address - Phone:912-441-8935
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-26
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Multi-Specialty