Organization · Type 2 NPI

Fairy Wings Mobile Phlebotomy Service LLC

Health Service Clinic/Center · Gulfport, MS

NPI number 1316517329 Active

Practice location

549 E Pass Rd Ste J
Gulfport, MS 39507-3261

Fax (228) 284-5724

Specialties and licenses

Taxonomy	Code	License
Health Service Clinic/Center Primary	261QH0100X	None listed
Clinical Medical Laboratory	291U00000X	None listed
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
Non-emergency Medical Transport (VAN)	343900000X	None listed
Private Vehicle	347C00000X	None listed

Health Service Clinic/Center: Definition to come...

Another provider at this address

Tomieko Threadgill, PHLEBO, MA, CMLAPhlebotomy Technician Gulfport, MS NPI 1972120525

NPI record

NPI: 1316517329
Entity type: Organization (Type 2)
Issued: Jun 30, 2021
Last updated: Apr 11, 2023
Status: Active

Other names

<unavail>
Fairy Wings Laboratory and Specialty Services · doing business as

Authorized official

Ms. Tomieko Threadgill, PHLEBOT, NCMA, NCMLA
Owner
(228) 284-4176

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1316517329

Fairy Wings Mobile Phlebotomy Service LLC's National Provider Identifier is 1316517329, issued on Jun 30, 2021. The primary taxonomy on file is Health Service Clinic/Center (261QH0100X), and the practice location is in Gulfport, MS. The record was last updated on Apr 11, 2023.