Healthcare Provider Details
I. General information
NPI: 1871403071
Provider Name (Legal Business Name): SPARKOVATE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8348 E SELLS DR
SCOTTSDALE AZ
85251-2819
US
IV. Provider business mailing address
8348 E SELLS DR
SCOTTSDALE AZ
85251-2819
US
V. Phone/Fax
- Phone: 657-427-0317
- Fax:
- Phone: 657-427-0317
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ADAM
SOLOMON
Title or Position: CEO
Credential:
Phone: 657-427-0317