Provider Demographics
NPI:1912743741
Name:MINNIX VEIN EASE EXPRESS LLC
Entity type:Organization
Organization Name:MINNIX VEIN EASE EXPRESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHELEBOTOMIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MINNIX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-678-9184
Mailing Address - Street 1:518 CHOCTAW DR
Mailing Address - Street 2:
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570-6512
Mailing Address - Country:US
Mailing Address - Phone:337-678-9184
Mailing Address - Fax:
Practice Address - Street 1:518 CHOCTAW DR
Practice Address - Street 2:
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-6512
Practice Address - Country:US
Practice Address - Phone:337-678-9184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty