Healthcare Provider Details
I. General information
NPI: 1114953221
Provider Name (Legal Business Name): SOUTHWESTERN EYE CENTER LTD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/23/2006
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
110 S IDAHO RD STE 160
APACHE JUNCTION AZ
85119-2318
US
IV. Provider business mailing address
63 S ROCKFORD DR STE 220
TEMPE AZ
85288-6226
US
V. Phone/Fax
- Phone: 480-982-0241
- Fax: 602-508-4830
- Phone: 602-598-7488
- Fax: 602-231-6215
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ARTHUR
D
BROOKFIELD
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 602-598-7488