Healthcare Provider Details

I. General information

NPI: 1356954408
Provider Name (Legal Business Name): PRECISION PHLEBOTOMY,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2020
Last Update Date: 08/28/2020
Certification Date: 08/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11807 ALLISONVILLE RD # 627
FISHERS IN
46038-2313
US

IV. Provider business mailing address

11807 ALLISONVILLE RD # 627
FISHERS IN
46038-2313
US

V. Phone/Fax

Practice location:
  • Phone: 317-754-8818
  • Fax:
Mailing address:
  • Phone: 317-754-8818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State

VIII. Authorized Official

Name: BRANDI S. YANCEY
Title or Position: OWNER
Credential:
Phone: 317-754-8818