Provider Demographics
NPI:1134813967
Name:RENOTTA'S GENTLE HANDS PHLEBOTOMY
Entity type:Organization
Organization Name:RENOTTA'S GENTLE HANDS PHLEBOTOMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RENOTTA
Authorized Official - Middle Name:
Authorized Official - Last Name:JEFFERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-480-6608
Mailing Address - Street 1:25054 LAMBS MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:WORTON
Mailing Address - State:MD
Mailing Address - Zip Code:21678-1919
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25054 LAMBS MEADOW RD
Practice Address - Street 2:
Practice Address - City:WORTON
Practice Address - State:MD
Practice Address - Zip Code:21678-1919
Practice Address - Country:US
Practice Address - Phone:443-480-6608
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health