1St. Stick Medical Draw Station

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

246RP1900X Issued in VA

Legal business name

1ST. STICK MEDICAL DRAW STATION

Doing business as

1st. Stick Medical

Practice address

1405 Westover Hills Blvd Ste 1a
Richmond, VA 23225-3153

Phone

(804) 424-3260

Fax

(804) 424-3261

NPI assigned

Aug 22, 2017

Last updated

Sep 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Telly Leshan OwensNPI 1306368907

Title

Ceo

Phone

(804) 424-3260

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• 1st. Stick Medical Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Telly Leshan Owens

  • Phlebotomy Technician
  • Richmond, VA
  • NPI 1306368907
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1503360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600732800000",
    "number": "1043736911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4331 BATHGATE RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232343581",
            "telephone_number": "804-549-9115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 WESTOVER HILLS BLVD STE 1A",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232253153",
            "telephone_number": "804-424-3260",
            "fax_number": "804-424-3261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1ST. STICK MEDICAL DRAW STATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-22",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A",
        "authorized_official_last_name": "OWENS",
        "authorized_official_first_name": "TELLY",
        "authorized_official_middle_name": "LESHAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "804-424-3260"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "VA",
            "license": "246RP1900X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306368907",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "1st. Stick Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Medical Laboratory in Richmond, VA
• Providers in Richmond, VA by specialty
• Clinical Medical Laboratory in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.