Phlebotech LLC

Primary specialty

Phlebotomy TechnicianTaxonomy code 246RP1900X

Legal business name

PHLEBOTECH LLC

Practice address

430 Random Rd
Baltimore, MD 21229-3928

Phone

(240) 651-8346

Fax

(240) 457-4486

NPI assigned

Sep 1, 2021

Organization subpart

No

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

Authorized official

Name

Ebonie Fulwood, CERTIFICATION

Title

Phlebotomist / Cpi

Phone

(443) 455-4683

Specialties & licenses 1

Addresses

Other names 2

• Phlebotech LLC Former legal business name
• Phlebotech Mobile Phlebotomy Business Other name

Electronic endpoints 1

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

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630454400000",
    "number": "1235807629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 RANDOM RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212293928",
            "telephone_number": "240-651-8346",
            "fax_number": "240-457-4486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 RANDOM RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212293928",
            "telephone_number": "240-651-8346",
            "fax_number": "240-457-4486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHLEBOTECH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-01",
        "last_updated": "2021-09-01",
        "certification_date": "2021-08-26",
        "status": "A",
        "authorized_official_last_name": "FULWOOD",
        "authorized_official_first_name": "EBONIE",
        "authorized_official_title_or_position": "PHLEBOTOMIST / CPI",
        "authorized_official_telephone_number": "443-455-4683",
        "authorized_official_credential": "CERTIFICATION"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "phlebotech@outlook.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2102 Whitehall Rd Unit 1B",
            "city": "Frederick",
            "state": "MD",
            "country_code": "US",
            "postal_code": "217026436",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Phlebotech LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Phlebotech Mobile Phlebotomy Business",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mary Carmelle Philogene, PHD
• Benjamin Philosophe, M.D.
• Elizabeth Philpot, RN
• Michael Schofield Phipps, M.D.
• Kristen Phiri, M.D.
• Phlebotomy Mobile Labs LLC
• Phlebotomy on Wheels
• Pho-Vital Signs
• Esther Phocole
• Erin Noel Phoebus, LCPC, LGPAT, ATR

• Phlebotomy Technician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Phlebotomy Technician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; 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.