Healthcare Provider Details

I. General information

NPI: 1477112167
Provider Name (Legal Business Name): BENNETT MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2019
Last Update Date: 04/25/2021
Certification Date: 04/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4130 E WOOD ST STE 180
PHOENIX AZ
85040-1972
US

IV. Provider business mailing address

220 W GERMANTOWN PIKE STE 250
PLYMOUTH MEETING PA
19462-1437
US

V. Phone/Fax

Practice location:
  • Phone: 702-382-4940
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN GRIGGS
Title or Position: CEO
Credential:
Phone: 407-206-0040