Provider Demographics
NPI:1710579545
Name:MOBILE PHLEBOTOMY OF THE SOUTH
Entity Type:Organization
Organization Name:MOBILE PHLEBOTOMY OF THE SOUTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARGO
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:PJLEBOTOMIST
Authorized Official - Phone:225-384-6657
Mailing Address - Street 1:8611 FOREST GLEN AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70812-4601
Mailing Address - Country:US
Mailing Address - Phone:225-384-6657
Mailing Address - Fax:866-628-9103
Practice Address - Street 1:8611 FOREST GLEN AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70812-4601
Practice Address - Country:US
Practice Address - Phone:225-384-6657
Practice Address - Fax:866-628-9103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Multi-Specialty