Healthcare Provider Details

I. General information

NPI: 1023986502
Provider Name (Legal Business Name): SAFFOLD MOBILE MEDICAL SERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2025
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2647 HOMECROFT DR
COLUMBUS OH
43211-1020
US

IV. Provider business mailing address

2647 HOMECROFT DR
COLUMBUS OH
43211-1020
US

V. Phone/Fax

Practice location:
  • Phone: 614-407-4863
  • Fax:
Mailing address:
  • Phone: 614-407-4863
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code246Q00000X
TaxonomyPathology Specialist/Technologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: ALISHA D SAFFOLD
Title or Position: PHEBOTOMIST
Credential:
Phone: 614-407-4863