MEDICARE: PAION INSTITUTE LLC

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	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	NV20151115320	NV

General Provider Information

NPI Number	:	1164971164
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAION INSTITUTE LLC

Provider Business Mailing Address
First Line	:	3960 HOWARD HUGHES PKWY
Second Line	:	SUITE 500
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-5972
Country	:	US
Telephone Number	:	425-351-5665
Fax Number	:

Provider Business Practice Location Address
First Line	:	7150 E CAMELBACK RD
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85251-1200
Country	:	US
Telephone Number	:	425-351-5665
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MICHAEL FITCH
Credential	:
Telephone Number	:	425-351-5665

Provider Enumeration Date	:	10/02/2016
Last Update Date	:	10/02/2016

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Directions to “PAION INSTITUTE LLC ” Practice Location

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