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General NPI Number Information
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NPI Number | 1134936966
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Entity Type | Organization
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Legal Business Name | TLC PHLEBTOMY SERVICES LLC
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 413 PALM ST
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City | GREEN COVE SPRINGS
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State | FL
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Zip | 32043-2736
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Country | US
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Telephone | 205-615-4381
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Fax |
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Provider Business Mailing Address
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Address Line | 656 LINWOOD AVE
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City | JACKSONVILLE
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State | FL
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Zip | 32206-6249
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Country | US
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Telephone | 205-615-4381
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TAMYCA EPTING
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Credential | PHLEBOTOMIST
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Telephone | 205-615-4381
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number |
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License Number State |
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