Provider Demographics
NPI:1962791970
Name:PHLEBOTOMY SERVICES PLUS LLC
Entity type:Organization
Organization Name:PHLEBOTOMY SERVICES PLUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:LENITA
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:PHLEBOTOMIST
Authorized Official - Phone:800-671-9496
Mailing Address - Street 1:1160 RIVERVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63147-1707
Mailing Address - Country:US
Mailing Address - Phone:800-671-9496
Mailing Address - Fax:800-671-9540
Practice Address - Street 1:1160 RIVERVIEW BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63147-1707
Practice Address - Country:US
Practice Address - Phone:800-671-9496
Practice Address - Fax:800-671-9540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-30
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory