Healthcare Provider Details

I. General information

NPI: 1124116652
Provider Name (Legal Business Name): F AND M BUILDERS LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 05/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 N. SPITZ SPRINGS ROAD
PARKS AZ
86018
US

IV. Provider business mailing address

PO BOX 30010
FLAGSTAFF AZ
86003-0010
US

V. Phone/Fax

Practice location:
  • Phone: 928-635-4399
  • Fax: 928-635-4399
Mailing address:
  • Phone: 928-635-4399
  • Fax: 928-635-4399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number176106
License Number StateAZ

VIII. Authorized Official

Name: MR. PAUL ANTHONY FERRY
Title or Position: PARTNER
Credential:
Phone: 928-635-4399