Provider Demographics
NPI:1871908327
Name:PHLEBOTOMY MOBILE SERVICES, LLC
Entity type:Organization
Organization Name:PHLEBOTOMY MOBILE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:CUINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-620-4254
Mailing Address - Street 1:P.O. BOX 440305
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80044
Mailing Address - Country:US
Mailing Address - Phone:720-620-4254
Mailing Address - Fax:
Practice Address - Street 1:2323 S TROY ST
Practice Address - Street 2:BLDG 5 STE 101
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1946
Practice Address - Country:US
Practice Address - Phone:720-620-4254
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-24
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QH0100X
CO06D2085676291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service