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NPI Code Detail

MEDICARE: CONVENIENT CARE MOBILE PHLEBOTOMY LAB

MEDICARE: CONVENIENT CARE MOBILE PHLEBOTOMY LAB
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
1172V00000XCommunity Health WorkerOH

General Provider Information

NPI Number : 1871036269
Entity Type Code : Organization
Provider Name (Legal Business Name) : CONVENIENT CARE MOBILE PHLEBOTOMY LAB
Provider Business Mailing Address
First Line : 13381 WOLF AVE
Second Line :
City : GARFIELD HTS
State : OH
Zip : 44125-3766
Country : US
Telephone Number : 216-931-6222
Fax Number :
Provider Business Practice Location Address
First Line : 13381 WOLF AVE
Second Line :
City : GARFIELD HTS
State : OH
Zip : 44125-3766
Country : US
Telephone Number : 216-931-6222
Fax Number :
Authorized Official
Title or Position : MEMBER
Name : SALICE BERLIN HARTFIELD
Credential : PHLEBOTOMIST
Telephone Number : 216-931-6222
Provider Enumeration Date : 12/02/2016
Last Update Date : 12/02/2016

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Directions to “CONVENIENT CARE MOBILE PHLEBOTOMY LAB ” Practice Location

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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.