Healthcare Provider Details

I. General information

NPI: 1346272887
Provider Name (Legal Business Name): HEALTHCARE INNOVATIONS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 03/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 S OCOTILLO AVE
BENSON AZ
85602-6403
US

IV. Provider business mailing address

PO BOX 1348
BENSON AZ
85602-1348
US

V. Phone/Fax

Practice location:
  • Phone: 520-586-7617
  • Fax: 520-586-2689
Mailing address:
  • Phone: 520-586-7617
  • Fax: 520-586-2689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberCON 103
License Number StateAZ

VIII. Authorized Official

Name: JIM BROOME
Title or Position: CEO/PRESIDENT
Credential:
Phone: 520-586-7617