Provider Demographics
NPI:1245676865
Name:DONNA M DCIKS-NORMAN
Entity type:Organization
Organization Name:DONNA M DCIKS-NORMAN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DICKS-NORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHLEBOTOMIST (MA)
Authorized Official - Phone:215-365-3851
Mailing Address - Street 1:2611 S 66TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19142-2802
Mailing Address - Country:US
Mailing Address - Phone:215-365-3851
Mailing Address - Fax:215-365-3861
Practice Address - Street 1:2611 S 66TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19142-2802
Practice Address - Country:US
Practice Address - Phone:215-365-3851
Practice Address - Fax:215-365-3861
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHOICEPOINT PHLEBOTOMY (MOBILE)
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health