Provider Demographics
NPI:1235961459
Name:NORTHERN SKY PHLEBOTOMY SERVICES, LLC
Entity type:Organization
Organization Name:NORTHERN SKY PHLEBOTOMY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-302-1674
Mailing Address - Street 1:6633 BRAYTON DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-2127
Mailing Address - Country:US
Mailing Address - Phone:907-302-1674
Mailing Address - Fax:907-268-4228
Practice Address - Street 1:6633 BRAYTON DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-2127
Practice Address - Country:US
Practice Address - Phone:907-302-1674
Practice Address - Fax:907-268-4228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-16
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty