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General NPI Number Information
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NPI Number | 1336002765
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Entity Type | Organization
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Legal Business Name | PHLEBOTOMIST ON CALL THEBLOODLINE, LLC
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 1301 YORK RD STE 800
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City | LUTHERVILLE TIMONIUM
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State | MD
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Zip | 21093-6011
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Country | US
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Telephone | 410-940-2221
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Fax | 208-608-5063
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Provider Business Mailing Address
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Address Line | 1301 YORK RD STE 800
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City | LUTHERVILLE TIMONIUM
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State | MD
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Zip | 21093-6011
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Country | US
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Telephone | 410-940-2221
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Fax | 208-608-5063
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Authorized Official
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Title or Position | CEO
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Name | BERNETHA ANN MCGREW
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Credential | PHLEBOTOMYTECHNICIAN
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Telephone | 410-940-2221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2472R0900X
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Taxonomy Name | Renal Dialysis Technician
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License Number |
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License Number State |
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Taxonomy #2
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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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