Provider Demographics
NPI:1518666510
Name:M&M MOBILE PHLEBOTOMY LLC
Entity Type:Organization
Organization Name:M&M MOBILE PHLEBOTOMY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHLEBOTOMIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MALEKA
Authorized Official - Middle Name:NATREASE
Authorized Official - Last Name:PATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:CPT
Authorized Official - Phone:313-644-0046
Mailing Address - Street 1:607 SHELBY ST STE 700
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48226-3282
Mailing Address - Country:US
Mailing Address - Phone:313-644-0046
Mailing Address - Fax:
Practice Address - Street 1:4696 DREXEL ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48215-2005
Practice Address - Country:US
Practice Address - Phone:313-644-0046
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty