MEDICARE: SAVANNAH EBONY LOVE PHLEBOTOMIST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246RP1900X	Phlebotomy Technician	K6P8R4M9	AZ

General Provider Information

NPI Number	:	1588596183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAVANNAH EBONY LOVE PHLEBOTOMIST

Provider Business Mailing Address
First Line	:	1218 ONYX LN
Second Line	:
City	:	BULLHEAD CITY
State	:	AZ
Zip	:	86442-7047
Country	:	US
Telephone Number	:	928-444-6823
Fax Number	:

Provider Business Practice Location Address
First Line	:	603 MARINA BLVD STE 17A
Second Line	:
City	:	BULLHEAD CITY
State	:	AZ
Zip	:	86442-5414
Country	:	US
Telephone Number	:	833-728-9522
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2026
Last Update Date	:	05/30/2026

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Directions to “ SAVANNAH EBONY LOVE PHLEBOTOMIST” Practice Location

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