The 360 Phlebotomy LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

THE 360 PHLEBOTOMY LLC

Doing business as

360 Onsite Laboratory

Practice address

5335 N Tacoma Ave
Indianapolis, IN 46220-3659

Phone

(317) 360-2421

NPI assigned

Jun 25, 2024

Last updated

Jun 25, 2024By 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

Vanessa D GorhamNPI 1821838251

Title

Owner

Phone

(317) 360-2421

Specialties & licenses 1

Addresses

Other names 1

• 360 Onsite Laboratory Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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.

• Vanessa D Gorham

  • Attendant Care Provider
  • Indianapolis, IN
  • NPI 1821838251
  NPD Authorized official

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

{
    "created_epoch": "1719273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719273600000",
    "number": "1962247767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11653 STOEPPELWERTH DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462294244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5335 N TACOMA AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462203659",
            "telephone_number": "317-360-2421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE 360 PHLEBOTOMY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-25",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A",
        "authorized_official_last_name": "GORHAM",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-360-2421"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "360 Onsite Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Health Service Clinic/Center in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Health Service Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.