Healthcare Provider Details
I. General information
NPI: 1609467349
Provider Name (Legal Business Name): EIR,LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/26/2021
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8755 E BELL RD # 200
SCOTTSDALE AZ
85260-1309
US
IV. Provider business mailing address
9343 E BAHIA DR STE 104
SCOTTSDALE AZ
85260-1559
US
V. Phone/Fax
- Phone: 480-562-6610
- Fax: 480-256-1679
- Phone: 623-223-8409
- Fax: 480-534-4061
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SANTINO
D
PRATO
Title or Position: CEO
Credential: DO
Phone: 623-223-8409