Healthcare Provider Details

I. General information

NPI: 1174804546
Provider Name (Legal Business Name): CONEY'S ON THE GO COURIER & PHLEBOTOMY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2011
Last Update Date: 08/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35356 FLEETWOOD DR
SLIDELL LA
70460-4210
US

IV. Provider business mailing address

35356 FLEETWOOD DR
SLIDELL LA
70460-4210
US

V. Phone/Fax

Practice location:
  • Phone: 888-660-4432
  • Fax: 800-507-4922
Mailing address:
  • Phone: 888-660-4432
  • Fax: 800-507-4922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name: MR. BRANDON LEE CONEY
Title or Position: OWNER
Credential:
Phone: 888-660-4432