Healthcare Provider Details

I. General information

NPI: 1114240785
Provider Name (Legal Business Name): CAREMERIDIAN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2010
Last Update Date: 08/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15032 N. 37TH AVE.
PHOENIX AZ
85053-4620
US

IV. Provider business mailing address

18-A JOURNEY SUITE 200
ALISO VIEJO CA
92656-5342
US

V. Phone/Fax

Practice location:
  • Phone: 602-942-1744
  • Fax: 602-687-1112
Mailing address:
  • Phone: 949-263-6632
  • Fax: 949-261-0457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License NumberAL8380H
License Number StateAZ

VIII. Authorized Official

Name: MR. SEAN SHEA
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 617-688-5251