Provider Demographics
NPI:1902693914
Name:PRECISION MOBILE PHLEBOTOMY LLC
Entity type:Organization
Organization Name:PRECISION MOBILE PHLEBOTOMY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PITTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHLEBOTOMIST
Authorized Official - Phone:601-596-2795
Mailing Address - Street 1:109 CITY PARK CIR
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39401-4934
Mailing Address - Country:US
Mailing Address - Phone:601-596-2795
Mailing Address - Fax:
Practice Address - Street 1:109 CITY PARK CIR
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-4934
Practice Address - Country:US
Practice Address - Phone:601-596-2795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
No291900000XLaboratoriesMilitary Clinical Medical Laboratory