Healthcare Provider Details
I. General information
NPI: 1043185689
Provider Name (Legal Business Name): ARIZONA MEDICAL SUPPLY & EQUIPMENT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/06/2025
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5433 W SAINT JOHN RD
GLENDALE AZ
85308-5384
US
IV. Provider business mailing address
5433 W SAINT JOHN RD
GLENDALE AZ
85308-5384
US
V. Phone/Fax
- Phone: 623-986-5731
- Fax: 623-986-5731
- Phone: 623-986-5731
- Fax: 623-986-5731
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:
MAJA
SUTKOVIC
Title or Position: OWNER
Credential:
Phone: 623-986-5731