Provider Demographics
NPI:1134761000
Name:TRAVELING PHLEBOTOMISTS
Entity type:Organization
Organization Name:TRAVELING PHLEBOTOMISTS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHLEBOTOMISTS
Authorized Official - Prefix:
Authorized Official - First Name:TANISHA
Authorized Official - Middle Name:NEKITA
Authorized Official - Last Name:DEMESSA
Authorized Official - Suffix:
Authorized Official - Credentials:RMA/RPT
Authorized Official - Phone:240-636-1449
Mailing Address - Street 1:PO BOX 4341
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20914-4341
Mailing Address - Country:US
Mailing Address - Phone:240-636-1449
Mailing Address - Fax:443-795-4966
Practice Address - Street 1:8403 COLESVILLE RD STE 1100
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-6346
Practice Address - Country:US
Practice Address - Phone:301-388-8431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-12
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty