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General NPI Number Information
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NPI Number | 1417798786
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Entity Type | Organization
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Legal Business Name | ON-THE-GO MOBILE BLOOD SERVICES LLC
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 12370 POTRANCO RD STE 207
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City | SAN ANTONIO
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State | TX
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Zip | 78253-4261
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Country | US
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Telephone | 210-514-0705
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Fax |
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Provider Business Mailing Address
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Address Line | 12370 POTRANCO RD STE 207
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City | SAN ANTONIO
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State | TX
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Zip | 78253-4261
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Country | US
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Telephone | 210-514-0705
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Fax |
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Authorized Official
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Title or Position | OWNER/ OPERATOR
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Name | JESSICA ELIZABETH-ANN DAVIS
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Credential | NRCMA, NRCPT
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Telephone | 210-514-0705
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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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