MEDICARE: F AND M BUILDERS LLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171WH0202X	Home Modifications Contractor	176106	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	483602	OTHER	AZ	PROVIDER ID NUMBER

General Provider Information

NPI Number	:	1124116652
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	F AND M BUILDERS LLP

Provider Business Mailing Address
First Line	:	PO BOX 30010
Second Line	:
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86003-0010
Country	:	US
Telephone Number	:	928-635-4399
Fax Number	:	928-635-4399

Provider Business Practice Location Address
First Line	:	68 N. SPITZ SPRINGS ROAD
Second Line	:
City	:	PARKS
State	:	AZ
Zip	:	86018
Country	:	US
Telephone Number	:	928-635-4399
Fax Number	:	928-635-4399

Authorized Official
Title or Position	:	PARTNER
Name	:	MR. PAUL ANTHONY FERRY
Credential	:
Telephone Number	:	928-635-4399

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	05/20/2010

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