Healthcare Provider Details

I. General information

NPI: 1942428107
Provider Name (Legal Business Name): REM MEDICAL AZ LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9305 W THOMAS RD STE 305
PHOENIX AZ
85037-3328
US

IV. Provider business mailing address

PO BOX 6687
MESA AZ
85216-6687
US

V. Phone/Fax

Practice location:
  • Phone: 623-271-9323
  • Fax: 623-321-6302
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ERIC PAGE
Title or Position: PRESIDENT
Credential:
Phone: 480-991-0480