Provider Demographics
NPI:1538810254
Name:BLESSED HANDS PHLEBOTOMY LTD.
Entity type:Organization
Organization Name:BLESSED HANDS PHLEBOTOMY LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CPT
Authorized Official - Prefix:
Authorized Official - First Name:KELYEA
Authorized Official - Middle Name:S
Authorized Official - Last Name:DERRICKS
Authorized Official - Suffix:
Authorized Official - Credentials:CPT,STNA
Authorized Official - Phone:937-204-6762
Mailing Address - Street 1:2505 YOLANDA DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-4467
Mailing Address - Country:US
Mailing Address - Phone:937-204-6762
Mailing Address - Fax:937-660-6876
Practice Address - Street 1:2505 YOLANDA DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-4467
Practice Address - Country:US
Practice Address - Phone:937-204-6762
Practice Address - Fax:937-660-6876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty