Healthcare Provider Details

I. General information

NPI: 1609212760
Provider Name (Legal Business Name): PINNACLE MOBILE PHLEBOTOMY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2013
Last Update Date: 09/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27620 FARMINGTON RD UNIT B2
FARMINGTON HILLS MI
48334-3349
US

IV. Provider business mailing address

PO BOX 3452
SOUTHFIELD MI
48037-3452
US

V. Phone/Fax

Practice location:
  • Phone: 248-702-5551
  • Fax: 877-678-3727
Mailing address:
  • Phone: 248-702-5551
  • Fax: 877-678-3727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY MITCHELL
Title or Position: CEO
Credential:
Phone: 248-702-5551