Provider Demographics
NPI:1194379800
Name:HANDS OF ANGELS PHLEBOTOMY SCHOOL AND MOBILE SERVICES LLC
Entity type:Organization
Organization Name:HANDS OF ANGELS PHLEBOTOMY SCHOOL AND MOBILE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHLEBOTOMIST
Authorized Official - Prefix:
Authorized Official - First Name:JESSIECA
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-623-0708
Mailing Address - Street 1:2625 CALLE DE FELIZ ST
Mailing Address - Street 2:
Mailing Address - City:GAUTIER
Mailing Address - State:MS
Mailing Address - Zip Code:39553-6848
Mailing Address - Country:US
Mailing Address - Phone:228-623-0708
Mailing Address - Fax:
Practice Address - Street 1:2625 CALLE DE FELIZ ST
Practice Address - Street 2:
Practice Address - City:GAUTIER
Practice Address - State:MS
Practice Address - Zip Code:39553-6848
Practice Address - Country:US
Practice Address - Phone:228-623-0708
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-31
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty