Provider Demographics
NPI:1922736214
Name:MANI&FLOW VENIPUNCTURE COMPANY
Entity Type:Organization
Organization Name:MANI&FLOW VENIPUNCTURE COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:FLORENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:CNA, CPT
Authorized Official - Phone:815-386-0981
Mailing Address - Street 1:189 N QUINCY AVE
Mailing Address - Street 2:
Mailing Address - City:BRADLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60915-1841
Mailing Address - Country:US
Mailing Address - Phone:815-386-0981
Mailing Address - Fax:
Practice Address - Street 1:1880 N STATE ROUTE 50 STE 4
Practice Address - Street 2:
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-4432
Practice Address - Country:US
Practice Address - Phone:815-386-0981
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-12
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty
No251J00000XAgenciesNursing CareGroup - Single Specialty