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General NPI Number Information
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NPI Number | 1740106384
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Entity Type | Organization
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Legal Business Name | SPECIALTY MOBILE DIAGNOSTICS, LLC
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Dates
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Enumeration Date | 06/27/2026
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Last Update Date | 06/27/2026
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Provider Practice Location Address
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Address Line | 4709 HARFORD RD
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City | BALTIMORE
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State | MD
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Zip | 21214-3205
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Country | US
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Telephone | 410-240-0404
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Fax |
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Provider Business Mailing Address
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Address Line | 4709 HARFORD RD
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City | BALTIMORE
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State | MD
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Zip | 21214-3205
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Country | US
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Telephone | 410-240-0404
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Fax |
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Authorized Official
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Title or Position | FOUNDER & CEO
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Name | SIARA PRIDGEN
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Credential | PRIDGEN
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Telephone | 410-240-0404
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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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