Healthcare Provider Details

I. General information

NPI: 1134761000
Provider Name (Legal Business Name): TRAVELING PHLEBOTOMISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2019
Last Update Date: 12/10/2020
Certification Date: 12/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8403 COLESVILLE RD STE 1100
SILVER SPRING MD
20910-6346
US

IV. Provider business mailing address

PO BOX 4341
SILVER SPRING MD
20914-4341
US

V. Phone/Fax

Practice location:
  • Phone: 301-388-8431
  • Fax:
Mailing address:
  • Phone: 240-636-1449
  • Fax: 443-795-4966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TANISHA NEKITA DEMESSA
Title or Position: PHLEBOTOMISTS
Credential: RMA/RPT
Phone: 240-636-1449