Healthcare Provider Details

I. General information

NPI: 1609180264
Provider Name (Legal Business Name): FIBROMYALGIA CENTERS OF AMERICA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2010
Last Update Date: 08/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2390 N ALMA SCHOOL ROAD SUITE 121
CHANDLER AZ
85224-8004
US

IV. Provider business mailing address

2390 N ALMA SCHOOL ROAD SUITE 121
CHANDLER AZ
85224-8004
US

V. Phone/Fax

Practice location:
  • Phone: 480-361-6804
  • Fax: 480-895-2914
Mailing address:
  • Phone: 480-361-6804
  • Fax: 480-895-2914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number605-4718
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number035134
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number08-1051
License Number StateAZ

VIII. Authorized Official

Name: CRAIG ALLEN SCHERF
Title or Position: VP
Credential: MDA CLT CLI CSO ERM
Phone: 623-606-7808