Blue Ocean Laboratory Services LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

BLUE OCEAN LABORATORY SERVICES LLC

Practice address

115 Habersham Dr Ste B
Fayetteville, GA 30214-7353

Phone

(470) 593-9800

NPI assigned

Dec 16, 2020

Organization subpart

No

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

Authorized official

Name

Brian Dean

Title

Administrator

Phone

(614) 706-5206

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1608076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608076800000",
    "number": "1164018982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 CHAMBRAY HLS",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302694247",
            "telephone_number": "470-593-9800",
            "fax_number": "470-593-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 HABERSHAM DR STE B",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147353",
            "telephone_number": "470-593-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE OCEAN LABORATORY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-16",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A",
        "authorized_official_last_name": "DEAN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "614-706-5206"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latasha Latrice Blissett, LPC
• Sean Franklin Blithe, PT, DPT
• Ashlee Block, PA-C
• Fredric Darnell Blocker, LPC
• Tyra Blocker, RBT
• Board of Commissioners of Fayette County (Fayette County EMS)
• Body in Balance Chiropractic & Wellness Center, LLC
• Body Revolution Healthcare Consultants
• Body Therapy by George Massages LLC
• Camille Franncine Bolton, DPT

• Clinical Medical Laboratory in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Clinical Medical Laboratory in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.