MEDICARE: PAINMED 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	208VP0000X	Pain Medicine Physician

General Provider Information

NPI Number	:	1265885396
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAINMED LLC

Provider Business Mailing Address
First Line	:	7337 E THOMAS RD
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85251-7215
Country	:	US
Telephone Number	:	480-360-4444
Fax Number	:

Provider Business Practice Location Address
First Line	:	7337 E THOMAS RD
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85251-7215
Country	:	US
Telephone Number	:	480-360-4444
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOHN EBY
Credential	:
Telephone Number	:	602-679-7676

Provider Enumeration Date	:	07/13/2016
Last Update Date	:	07/13/2016

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Directions to “PAINMED LLC ” Practice Location

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