Healthcare Provider Details

I. General information

NPI: 1639880016
Provider Name (Legal Business Name): PHLEB CHOICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2022
Last Update Date: 12/07/2022
Certification Date: 12/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1635 GARMAN RD
AKRON OH
44313-6339
US

IV. Provider business mailing address

106 CHARLES ST
AKRON OH
44304-1127
US

V. Phone/Fax

Practice location:
  • Phone: 330-809-4266
  • Fax: 330-809-4266
Mailing address:
  • Phone: 330-809-4266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code331L00000X
TaxonomyBlood Bank
License Number
License Number State

VIII. Authorized Official

Name: MS. NICHELLE NICOLE LOPP
Title or Position: PHLEBOTOMIST
Credential:
Phone: 234-281-9878