Healthcare Provider Details

I. General information

NPI: 1164971164
Provider Name (Legal Business Name): PAION INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2016
Last Update Date: 10/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7150 E CAMELBACK RD
SCOTTSDALE AZ
85251-1200
US

IV. Provider business mailing address

3960 HOWARD HUGHES PKWY SUITE 500
LAS VEGAS NV
89169-5972
US

V. Phone/Fax

Practice location:
  • Phone: 425-351-5665
  • Fax:
Mailing address:
  • Phone: 425-351-5665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License NumberNV20151115320
License Number StateNV

VIII. Authorized Official

Name: MICHAEL FITCH
Title or Position: CEO
Credential:
Phone: 425-351-5665