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General NPI Number Information
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NPI Number | 1235812397
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Entity Type | Organization
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Legal Business Name | ROGUE SCHOOL OF PHLEBOTOMY LLC
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Dates
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Enumeration Date | 08/07/2023
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Last Update Date | 11/07/2023
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Provider Practice Location Address
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Address Line | 201 W MAIN ST STE 2C
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City | MEDFORD
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State | OR
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Zip | 97501-2744
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Country | US
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Telephone | 541-622-8053
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Fax |
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Provider Business Mailing Address
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Address Line | 201 W MAIN ST STE 2C
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City | MEDFORD
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State | OR
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Zip | 97501-2744
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Country | US
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Telephone | 541-622-8053
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Fax |
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Authorized Official
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Title or Position | OWNER/ PHLEBOTOMY PROGRAM DIRECTOR
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Name | HOPE A GUERRERO
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Credential | PBT(ASCP)
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Telephone | 541-622-8053
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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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