Southern Maryland Mobile Lab Services LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

SOUTHERN MARYLAND MOBILE LAB SERVICES LLC

Practice address

3965 Saint Charles Pkwy
Waldorf, MD 20602-2683

Phone

(240) 538-8571

Fax

(240) 607-7229

NPI assigned

Apr 28, 2023

Organization subpart

No

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

Authorized official

Name

Teaira Geneva MilburnNPI 1851903512

Title

Ceo

Phone

(240) 925-9449

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Teaira Geneva Milburn

  • Phlebotomy Technician
  • Waldorf, MD
  • NPI 1851903512
  NPD Authorized official

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

{
    "created_epoch": "1682640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682640000000",
    "number": "1740978576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3828 LAKEWOOD PL",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206021429",
            "telephone_number": "240-929-5944",
            "fax_number": "240-607-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3965 SAINT CHARLES PKWY",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022683",
            "telephone_number": "240-538-8571",
            "fax_number": "240-607-7229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MARYLAND MOBILE LAB SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-28",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A",
        "authorized_official_last_name": "MILBURN",
        "authorized_official_first_name": "TEAIRA",
        "authorized_official_middle_name": "GENEVA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "240-925-9449"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Maryland Community Network, Inc
• Southern Maryland Community Network, Inc.
• Southern Maryland Counseling & Coaching, LLC
• Southern Maryland Foot and Ankle LLC
• Southern Maryland General Surgery LLC
• Southern Maryland Oral & Maxillofacial Surgery
• Southern Maryland Physical Therapy, Inc
• Southern Maryland Primary Care, LLC
• Southern Maryland Pulmonary & Critical Care, P.a.
• Southern Maryland Speech and Language Services

• Health Service Clinic/Center in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Health Service Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2023; 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.