Healthcare Provider Details

I. General information

NPI: 1609223056
Provider Name (Legal Business Name): HEART HEALTH CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2016
Last Update Date: 06/13/2021
Certification Date: 06/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1848 E THOMAS RD SUITE 200
PHOENIX AZ
85016-8112
US

IV. Provider business mailing address

1848 E THOMAS RD STE 200
PHOENIX AZ
85016-8104
US

V. Phone/Fax

Practice location:
  • Phone: 602-456-2342
  • Fax:
Mailing address:
  • Phone: 602-456-2342
  • Fax: 602-688-2342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. VIJENDRA SWARUP
Title or Position: SOLE MEMBER
Credential: MD
Phone: 602-456-2342