Healthcare Provider Details

I. General information

NPI: 1780928135
Provider Name (Legal Business Name): INTERION GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2012
Last Update Date: 06/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4202 N 32ND ST SUITE F
PHOENIX AZ
85018-4746
US

IV. Provider business mailing address

4202 N 32ND ST SUITE F
PHOENIX AZ
85018-4746
US

V. Phone/Fax

Practice location:
  • Phone: 800-807-2372
  • Fax:
Mailing address:
  • Phone: 800-807-2372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberAS7450
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: DAMON SACKS
Title or Position: CHIEF OPERATIONS OFFICER
Credential: M.D.
Phone: 800-807-2372