Provider Demographics
NPI:1801402235
Name:MOBILE BLOOD WORK SERVICES L.L.C.
Entity type:Organization
Organization Name:MOBILE BLOOD WORK SERVICES L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHALON
Authorized Official - Middle Name:M
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-914-0657
Mailing Address - Street 1:16884 GREENVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219-4154
Mailing Address - Country:US
Mailing Address - Phone:248-914-0657
Mailing Address - Fax:
Practice Address - Street 1:16884 GREENVIEW AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-4154
Practice Address - Country:US
Practice Address - Phone:248-914-0657
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-21
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty