Healthcare Provider Details

I. General information

NPI: 1730348681
Provider Name (Legal Business Name): SYNERTX
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2008
Last Update Date: 06/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7540 N 19TH AVE STE 200
PHOENIX AZ
85021-7967
US

IV. Provider business mailing address

38 BEECHWOOD DR
STRAFFORD NH
03884-6802
US

V. Phone/Fax

Practice location:
  • Phone: 888-873-4221
  • Fax:
Mailing address:
  • Phone: 603-664-7144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number0199
License Number StateNH

VIII. Authorized Official

Name: MRS. LAURA HUTCHINSON SMITH
Title or Position: PT ASSISTANT
Credential:
Phone: 603-664-7144