MEDICARE: ROBINSON MOBILE PHLEBOTOMY

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	:	1952855215
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBINSON MOBILE PHLEBOTOMY

Provider Business Mailing Address
First Line	:	32455 W 12 MILE RD
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48333-9991
Country	:	US
Telephone Number	:	248-558-0036
Fax Number	:

Provider Business Practice Location Address
First Line	:	32455 W 12 MILE RD
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48333-9991
Country	:	US
Telephone Number	:	248-558-0036
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LATONIA ROBINSON
Credential	:
Telephone Number	:	313-286-9755

Provider Enumeration Date	:	08/04/2016
Last Update Date	:	08/04/2016

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