Provider Demographics
NPI:1568290823
Name:YOLANDAS MEDICAL ESTABLISHMENT
Entity type:Organization
Organization Name:YOLANDAS MEDICAL ESTABLISHMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHLEBOTOMIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SELDERS
Authorized Official - Suffix:
Authorized Official - Credentials:CPT/MA
Authorized Official - Phone:662-276-4040
Mailing Address - Street 1:510 LONGINO ST
Mailing Address - Street 2:
Mailing Address - City:BELZONI
Mailing Address - State:MS
Mailing Address - Zip Code:39038-3718
Mailing Address - Country:US
Mailing Address - Phone:662-276-4040
Mailing Address - Fax:
Practice Address - Street 1:401 HIGHWAY 82 W
Practice Address - Street 2:
Practice Address - City:INDIANOLA
Practice Address - State:MS
Practice Address - Zip Code:38751-2030
Practice Address - Country:US
Practice Address - Phone:662-276-4040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty