Provider Demographics
NPI:1578200697
Name:FAMILY MOBILE PHLEBOTOMY
Entity Type:Organization
Organization Name:FAMILY MOBILE PHLEBOTOMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARETHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRITTON
Authorized Official - Suffix:
Authorized Official - Credentials:NCPT
Authorized Official - Phone:404-277-7806
Mailing Address - Street 1:PO BOX 22892
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38122-0892
Mailing Address - Country:US
Mailing Address - Phone:404-277-7806
Mailing Address - Fax:
Practice Address - Street 1:3440 CARNES AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38111-4242
Practice Address - Country:US
Practice Address - Phone:901-643-2351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246R00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyGroup - Single Specialty