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General NPI Number Information
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NPI Number | 1457116964
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Entity Type | Organization
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Legal Business Name | MARYS MOBILE BLOOD DRAW & CARE
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Dates
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Enumeration Date | 02/14/2024
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Last Update Date | 02/14/2024
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Provider Practice Location Address
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Address Line | 2826 ANTONIO AVE
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City | CLOVIS
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State | CA
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Zip | 93611-3932
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Country | US
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Telephone | 559-909-8796
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Fax | 559-314-1950
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Provider Business Mailing Address
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Address Line | 2826 ANTONIO AVE
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City | CLOVIS
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State | CA
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Zip | 93611-3932
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Country | US
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Telephone | 559-909-8796
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Fax | 559-314-1950
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MRS. MARY HELEN RUNNELS
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Credential | RN
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Telephone | 559-909-8796
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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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