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NPI Code Detail

MEDICARE: PREMISE HEALTH OF ARIZONA MEDICAL PC

MEDICARE: PREMISE HEALTH OF ARIZONA MEDICAL PC
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
1261QM1300XMulti-Specialty Clinic/Center

General Provider Information

NPI Number : 1437885258
Entity Type Code : Organization
Provider Name (Legal Business Name) : PREMISE HEALTH OF ARIZONA MEDICAL PC
Provider Business Mailing Address
First Line : 5500 MARYLAND WAY STE 120
Second Line :
City : BRENTWOOD
State : TN
Zip : 37027-4993
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9831 W. TANGERINE ROAD
Second Line :
City : MARANA
State : AZ
Zip : 85653
Country : US
Telephone Number : 615-468-3188
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : EDWARD WILLIAMS SCHWARTZ
Credential :
Telephone Number : 844-407-7557
Provider Enumeration Date : 07/25/2022
Last Update Date : 02/04/2026

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Directions to “PREMISE HEALTH OF ARIZONA MEDICAL PC ” Practice Location

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