Healthcare Provider Details

I. General information

NPI: 1740854702
Provider Name (Legal Business Name): MEDICAL DME PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2021
Last Update Date: 05/14/2021
Certification Date: 05/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4910 W RAY RD STE 1
CHANDLER AZ
85226-6221
US

IV. Provider business mailing address

7904 E CHAPARRAL RD STE A110-475
SCOTTSDALE AZ
85250-7370
US

V. Phone/Fax

Practice location:
  • Phone: 480-710-4897
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: JIM ROSSIE
Title or Position: MANAGER
Credential:
Phone: 602-881-9560