Healthcare Provider Details

I. General information

NPI: 1366389868
Provider Name (Legal Business Name): STEADFAST CARE MOBILE PHLEBOTOMY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2616 N PARK AVE
MANSFIELD LA
71052-5738
US

IV. Provider business mailing address

2616 N PARK AVE
MANSFIELD LA
71052-5738
US

V. Phone/Fax

Practice location:
  • Phone: 318-461-8007
  • Fax:
Mailing address:
  • Phone: 318-461-8007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name: SHARONDA M GANT
Title or Position: OWNER/PHLEBOTOMIST
Credential: CCMA,CPT,CNA
Phone: 318-461-8007