Provider Demographics
NPI:1821745480
Name:ANGELS PHLEBOTOMY SERVICE LLC
Entity Type:Organization
Organization Name:ANGELS PHLEBOTOMY SERVICE LLC
Other - Org Name:ANGELS PHLEBOTOMY SERVICE LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:KIMBERLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:PHLEBOTOMIST
Authorized Official - Phone:504-356-2207
Mailing Address - Street 1:PO BOX 2094
Mailing Address - Street 2:
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70069-2094
Mailing Address - Country:US
Mailing Address - Phone:985-210-2563
Mailing Address - Fax:504-336-2070
Practice Address - Street 1:2015 W AIRLINE HWY
Practice Address - Street 2:
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-3031
Practice Address - Country:US
Practice Address - Phone:504-356-2207
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health