Healthcare Provider Details

I. General information

NPI: 1700501442
Provider Name (Legal Business Name): ON OUR WAY MOBILE PHLEBOTOMY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2022
Last Update Date: 10/13/2022
Certification Date: 10/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6350 TORRESDALE AVE
PHILADELPHIA PA
19135
US

IV. Provider business mailing address

6350 TORRESDALE AVE
PHILADELPHIA PA
19135
US

V. Phone/Fax

Practice location:
  • Phone: 267-997-3282
  • Fax: 215-914-9082
Mailing address:
  • Phone: 267-997-3282
  • Fax: 215-914-9082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CATHERINE ROSE ACHILLE
Title or Position: PHLEBOTOMIST/OWNER
Credential:
Phone: 267-997-3282