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General NPI Number Information
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NPI Number | 1154939817
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Entity Type | Organization
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Legal Business Name | SSR MOBILE PHLEBOTOMY AND SERVICES
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Dates
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Enumeration Date | 07/20/2020
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Last Update Date | 08/05/2020
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Provider Practice Location Address
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Address Line | 4009 LAKEHOUSE ROAD
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City | BELTSVILLE
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State | MD
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Zip | 20705
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Country | US
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Telephone | 240-459-8945
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Fax |
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Provider Business Mailing Address
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Address Line | 4009 LAKEHOUSE RD APT 05
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City | BELTSVILLE
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State | MD
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Zip | 20705-7526
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Country | US
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Telephone | 229-254-4575
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Fax |
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Authorized Official
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Title or Position | PHLEBOTOMY
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Name | ANASTASI WARD
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Credential | REGISTERED
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Telephone | 240-459-8945
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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