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General NPI Number Information
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NPI Number | 1700581568
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Entity Type | Organization
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Legal Business Name | BERKSHIRE PHLEBOTOMY AND TESTING SERVICES
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Dates
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Enumeration Date | 04/03/2023
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Last Update Date | 04/03/2023
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Provider Practice Location Address
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Address Line | 1608 MEMORIAL DR
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City | BURLINGTON
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State | NC
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Zip | 27215-4955
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Country | US
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Telephone | 919-352-9330
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Fax |
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Provider Business Mailing Address
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Address Line | 1608 MEMORIAL DR
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City | BURLINGTON
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State | NC
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Zip | 27215-4955
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRISHAWN TERRELL
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Credential |
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Telephone | 919-352-9330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083T0002X
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Taxonomy Name | Medical Toxicology (Preventive Medicine) Physician
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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 | 246RM2200X
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Taxonomy Name | Medical Laboratory Technician
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License Number |
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License Number State |
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Taxonomy #3
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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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