1568865871 NPI number — MOBI-VAMP MOBILE PHLEBOTOMY SERVICES, L.L.C.

Table of content: JENNIFER MAY CATALETA LCSW (NPI 1588833875)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568865871 NPI number — MOBI-VAMP MOBILE PHLEBOTOMY SERVICES, L.L.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MOBI-VAMP MOBILE PHLEBOTOMY SERVICES, L.L.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568865871
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/30/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2080 W FLOWAGE LAKE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST BRANCH
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48661-9374
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
989-709-6322
Provider Business Mailing Address Fax Number:
989-701-2532

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2080 W FLOWAGE LAKE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST BRANCH
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48661-9374
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
989-709-6322
Provider Business Practice Location Address Fax Number:
989-701-2532
Provider Enumeration Date:
09/30/2014

Additional Information

Authorized Official

Authorized Official Last Name:
SOCHOCKI
Authorized Official First Name:
JONI
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
989-709-6322

Provider Taxonomy Codes

  • Taxonomy code: 246RP1900X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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