Healthcare Provider Details

I. General information

NPI: 1649524968
Provider Name (Legal Business Name): THEMA MANAGEMENT COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2012
Last Update Date: 11/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2123 SUNSET PT SUITE B3
MIAMI AZ
85539-1347
US

IV. Provider business mailing address

7500 N DREAMY DRAW DR SUITE 105A
PHOENIX AZ
85020-4660
US

V. Phone/Fax

Practice location:
  • Phone: 928-425-8330
  • Fax: 928-425-8335
Mailing address:
  • Phone: 602-889-4400
  • Fax: 602-216-6112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: THERESA LUNGWITZ
Title or Position: CEO
Credential: RN
Phone: 602-889-4400