Healthcare Provider Details

I. General information

NPI: 1992579296
Provider Name (Legal Business Name): AMERICAN MEDICAL SOLUTIONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2023
Last Update Date: 11/08/2023
Certification Date: 11/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 W PARKSIDE LN STE 114
PHOENIX AZ
85027-1260
US

IV. Provider business mailing address

2222 W PARKSIDE LN STE 114
PHOENIX AZ
85027-1260
US

V. Phone/Fax

Practice location:
  • Phone: 602-997-7041
  • Fax: 602-997-7126
Mailing address:
  • Phone: 602-997-7041
  • Fax: 602-997-7126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 8
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 9
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 10
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 11
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 12
Primary TaxonomyN
Taxonomy Code364SC2300X
TaxonomyChronic Care Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY PUGLISI
Title or Position: PRESIDENT / CEO
Credential:
Phone: 602-997-7041