Provider Demographics
NPI:1518638873
Name:BASKIN'S MOBILE LAB & TESTING SERVICES LLC
Entity Type:Organization
Organization Name:BASKIN'S MOBILE LAB & TESTING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LAB DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:URSULA
Authorized Official - Middle Name:
Authorized Official - Last Name:PITTS-BASKIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:901-279-8573
Mailing Address - Street 1:6679 BEAGLE LN
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38002-5889
Mailing Address - Country:US
Mailing Address - Phone:901-279-8573
Mailing Address - Fax:
Practice Address - Street 1:6679 BEAGLE LN
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38002-5889
Practice Address - Country:US
Practice Address - Phone:901-279-8573
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-25
Last Update Date:2021-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory