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NPI Code Detail

MEDICARE: ON-THE-GO MOBILE BLOOD SERVICES LLC

MEDICARE: ON-THE-GO MOBILE BLOOD SERVICES 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
1246RP1900XPhlebotomy Technician

General Provider Information

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

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Directions to “ON-THE-GO MOBILE BLOOD SERVICES LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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