Healthcare Provider Details
I. General information
NPI: 1689417636
Provider Name (Legal Business Name): TRI-CITY CARDIOLOGY CONSULTANTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/17/2024
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6750 E BAYWOOD AVE STE 301
MESA AZ
85206-1749
US
IV. Provider business mailing address
6343 E MAIN ST STE 12
MESA AZ
85205-8955
US
V. Phone/Fax
- Phone: 480-835-6100
- Fax:
- Phone: 480-835-6100
- Fax: 480-461-4243
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WC3500X |
| Taxonomy | Cardiac Rehabilitation Registered Nurse |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
THOMAS
A
RITCHIE
Title or Position: MD/AO
Credential:
Phone: 480-835-6100