Organization
MOBILE TECH MEDICAL INC.
Active
Other names
Mobile Tech Medical laboratories
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD A JENKINS N/A (OWNER)
(225) 267-6860
Entity
Organization
Contact information
Practice address
4336 NORTH BLVD STE 200, BATON ROUGE, LA 70806-3920
(225) 267-6860
(225) 344-1133
Mailing address
4336 NORTH BLVD STE 200, BATON ROUGE, LA 70806-3920
(225) 267-6860
(225) 344-1133
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
19D1001395
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18313
PTAN
—
Enumeration date
04/12/2006
Last updated
01/08/2016
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