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IDESTA RALPH
NPI 1205235371
Technician, Pathology - Phlebotomy in Tyrone, GA

Active since August 14, 2014
1015 TYRONE RD # 410-C, TYRONE, GA 30290(470) 818-2264(866) 984-3729 Get Directions Write a Review

NPPES record last updated: June 10, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 27, 2021, Jul 23, 2021 (2 updates tracked since 2021).

About Idesta Ralph NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IDESTA RALPH (NPI 1205235371) is an individual phlebotomy provider in Tyrone, Georgia, licensed in New York (56083) and active in the NPI registry since August 2014.

NPPES Registry Identity

NPI1205235371
Entity TypeIndividualFemale
Primary Taxonomy246RP1900X
Provider Legal NameIDESTA RALPH
Location Address1015 TYRONE RD # 410-CTyrone, GA 30290-2407
Mailing Address5530 Old National Hwy Bldg 5530-b2College Park, GA 30349-6234 · (470) 818-2264 · Fax (866) 984-3729
Phone(470) 818-2264
Fax(866) 984-3729
Sole ProprietorYes
Enumeration DateAugust 14, 2014
Last NPPES UpdateJune 10, 20262 updates tracked since enumeration
NPPES CertifiedJune 10, 2026
✔ NPI 1205235371 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyTechnician, Pathology · PhlebotomyTechnologists, Technicians & Other Technical Service Providers
Taxonomy Code246RP1900X
License✔ Licensed in NY · 56083
1015 TYRONE RD # 410-C, Tyrone, GA 30290
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

IDESTA MEDICAL INC
Technician, Pathology (Phlebotomy)
1015 TYRONE RD # 410-C
TYRONE, GA 30290
Fayette County (470) 818-2264

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Idesta Ralph's NPI number?

The NPI number for Idesta Ralph is 1205235371. It was assigned to this individual provider in the NPPES registry on August 14, 2014.

Where is Idesta Ralph located?

Idesta Ralph practices at 1015 Tyrone Rd # 410-C, Tyrone, GA 30290. The listed phone number is (470) 818-2264.

What is Idesta Ralph's specialty?

The primary specialty registered for this NPI is Technician, Pathology, specializing in Phlebotomy, with taxonomy code 246RP1900X.

When was this NPI record last updated?

The NPPES record for Idesta Ralph was last updated on June 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.