MEDICARE: DML OPERATIONS 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	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1457836827
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DML OPERATIONS LLC

Provider Business Mailing Address
First Line	:	1934 E CAMELBACK RD # 120-301
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-4126
Country	:	US
Telephone Number	:	602-930-1528
Fax Number	:

Provider Business Practice Location Address
First Line	:	1934 E CAMELBACK RD # 120-301
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-4126
Country	:	US
Telephone Number	:	602-930-1528
Fax Number	:

Authorized Official
Title or Position	:	AMINISTRATOR
Name	:	DALE HOLMES
Credential	:	MHA
Telephone Number	:	602-930-1528

Provider Enumeration Date	:	10/01/2018
Last Update Date	:	10/01/2018

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Directions to “DML OPERATIONS LLC ” Practice Location

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