Provider Demographics
NPI:1881091320
Name:MEDINA HEALTH SERVCICES
Entity type:Organization
Organization Name:MEDINA HEALTH SERVCICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHLEBOTOMIST
Authorized Official - Prefix:
Authorized Official - First Name:ROSARIO
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-739-4686
Mailing Address - Street 1:3508 FARAH DR
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-5356
Mailing Address - Country:US
Mailing Address - Phone:806-577-6745
Mailing Address - Fax:979-485-9562
Practice Address - Street 1:3508 FARAH DR
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-5356
Practice Address - Country:US
Practice Address - Phone:806-577-6745
Practice Address - Fax:979-485-9562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-26
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty