Organization
MOBILE PHLEBOTOMY SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMALIA J HOSKINS PTB (OWNER/OPERATOR)
(708) 577-3206
Entity
Organization
Contact information
Practice address
7120 W 114TH ST, WORTH, IL 60482-2039
(708) 577-3206
(708) 586-2221
Mailing address
7120 W 114TH ST, WORTH, IL 60482-2039
(708) 577-3206
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
PBT(ASCP)38989
IL
305S00000X
Point of Service
Primary
PBT(ASCP)38989
IL
Other
Enumeration date
01/12/2015
Last updated
03/31/2015
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