Provider Demographics
NPI:1598357311
Name:ALVIONNA BREWSTER LLC
Entity Type:Organization
Organization Name:ALVIONNA BREWSTER LLC
Other - Org Name:ABUNDANT SEEDS HEALTH SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALVIONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BREWSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-996-4555
Mailing Address - Street 1:2044 OKLAHOMA AVE
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-2062
Mailing Address - Country:US
Mailing Address - Phone:972-996-4555
Mailing Address - Fax:
Practice Address - Street 1:2044 OKLAHOMA AVE
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-2062
Practice Address - Country:US
Practice Address - Phone:972-996-4555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-04
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory