MEDICARE: GENTLE STIX COLLECTION & TRAINING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246RP1900X	Phlebotomy Technician

General Provider Information

NPI Number	:	1346900453
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENTLE STIX COLLECTION & TRAINING LLC

Provider Business Mailing Address
First Line	:	8502 TWO NOTCH RD STE J-8
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29223-6307
Country	:	US
Telephone Number	:	833-436-8531
Fax Number	:

Provider Business Practice Location Address
First Line	:	8502 TWO NOTCH RD STE J-8
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29223-6307
Country	:	US
Telephone Number	:	833-436-8531
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	PIA CHELETTE SIMMONS
Credential	:
Telephone Number	:	803-476-7646

Provider Enumeration Date	:	12/30/2021
Last Update Date	:	02/23/2023

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