Organization Name: | A & W LABORATORIES |
NPI Number: | 1821352576 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ALISCHA NAKIA GWIN-WHITE (PHLEBOTOMIST) |
Mailing Address: | 3819 Warren Ave Apt 102 Bellwood |
State: | IL US |
Postal Code: | 601042058 |
Phone Number: | 7085439885 |
Fax Number: | |
NPI Enumeration Date: | 06/27/2012 |
NPI Last Update Date: | 06/27/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 246RP1900X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Technician, Pathology |
Taxonomy Specialization: | Phlebotomy |
Taxonomy Definition: |