Provider Demographics
NPI:1437497674
Name:B.A.T. COLLECTION SERVICE,LLC
Entity Type:Organization
Organization Name:B.A.T. COLLECTION SERVICE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHLEBOTOMIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TENITA
Authorized Official - Middle Name:R
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-884-3311
Mailing Address - Street 1:2207 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-3623
Mailing Address - Country:US
Mailing Address - Phone:318-509-8165
Mailing Address - Fax:
Practice Address - Street 1:2207 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-3623
Practice Address - Country:US
Practice Address - Phone:318-509-8165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-23
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAQ5P2L5Z7246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty