Organization
STICK AND GO MOBILE LAB SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAZMINE BROOKS CPT (TRAVEL PHLEBOTOMIST)
(708) 714-4935
Entity
Organization
Contact information
Practice address
2015 W WESTERN AVE, SOUTH BEND, IN 46619-3544
(800) 820-8210
Mailing address
137 S SHERIDAN ST, SOUTH BEND, IN 46619-1858
(708) 714-4935
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
—
—
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
—
—
261Q00000X
Clinic/Center
—
—
302R00000X
Health Maintenance Organization
Primary
—
—
331L00000X
Blood Bank
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396558912
—
IN
Enumeration date
02/28/2025
Last updated
02/28/2025
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