Provider Demographics
NPI:1467237487
Name:MOBILE PHLEBOTOMY SERVICES LLC
Entity Type:Organization
Organization Name:MOBILE PHLEBOTOMY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED PHLEBOTOMIST
Authorized Official - Prefix:
Authorized Official - First Name:MASUE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINSON
Authorized Official - Suffix:
Authorized Official - Credentials:CPT-02164406
Authorized Official - Phone:916-879-3308
Mailing Address - Street 1:965 CRYSTAL OAK PL
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:CA
Mailing Address - Zip Code:95658-9405
Mailing Address - Country:US
Mailing Address - Phone:916-879-3308
Mailing Address - Fax:
Practice Address - Street 1:965 CRYSTAL OAK PL
Practice Address - Street 2:
Practice Address - City:NEWCASTLE
Practice Address - State:CA
Practice Address - Zip Code:95658-9405
Practice Address - Country:US
Practice Address - Phone:916-879-3308
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty