Healthcare Provider Details

I. General information

NPI: 1568865871
Provider Name (Legal Business Name): MOBI-VAMP MOBILE PHLEBOTOMY SERVICES, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2014
Last Update Date: 09/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2080 W FLOWAGE LAKE RD
WEST BRANCH MI
48661-9374
US

IV. Provider business mailing address

2080 W FLOWAGE LAKE RD
WEST BRANCH MI
48661-9374
US

V. Phone/Fax

Practice location:
  • Phone: 989-709-6322
  • Fax: 989-701-2532
Mailing address:
  • Phone: 989-709-6322
  • Fax: 989-701-2532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. JONI MARIE SOCHOCKI
Title or Position: OWNER
Credential:
Phone: 989-709-6322