Healthcare Provider Details

I. General information

NPI: 1134050735
Provider Name (Legal Business Name): LUCKY PENNIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 N 95TH AVE STE 132
PHOENIX AZ
85037-4445
US

IV. Provider business mailing address

1106 W BELL RD APT 2154
PHOENIX AZ
85023-7944
US

V. Phone/Fax

Practice location:
  • Phone: 623-932-6950
  • Fax:
Mailing address:
  • Phone: 623-759-3098
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code235500000X
TaxonomySpeech/Language/Hearing Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: ERIC M TURNER
Title or Position: MANAGER
Credential:
Phone: 623-759-3098