Provider Demographics
NPI:1780096669
Name:LMM PHLEBOTOMY SERVICES LLC
Entity type:Organization
Organization Name:LMM PHLEBOTOMY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHLEBOTOMIST
Authorized Official - Prefix:
Authorized Official - First Name:LANETRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MONROE
Authorized Official - Suffix:
Authorized Official - Credentials:CPT
Authorized Official - Phone:419-471-7133
Mailing Address - Street 1:2762 CARROLTON CLUB CIR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-3186
Mailing Address - Country:US
Mailing Address - Phone:419-371-7133
Mailing Address - Fax:
Practice Address - Street 1:2762 CARROLTON CLUB CIR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-3186
Practice Address - Country:US
Practice Address - Phone:419-371-7133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-27
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHQ2L6Q8Q6331L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes331L00000XSuppliersBlood Bank