Healthcare Provider Details

I. General information

NPI: 1871551903
Provider Name (Legal Business Name): NEB GROUP OF ARIZONA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 04/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8261 E. EVANS RD SUITE 102
SCOTTSDALE AZ
85260
US

IV. Provider business mailing address

8711 E. PINNACLE PEAK RD. PMB PMB 327
SCOTTSDALE AZ
85255
US

V. Phone/Fax

Practice location:
  • Phone: 480-595-7272
  • Fax: 480-595-7273
Mailing address:
  • Phone: 480-595-7272
  • Fax: 480-595-7273

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: JACKIE KEENE
Title or Position: OWNER
Credential:
Phone: 480-595-7272