Healthcare Provider Details

I. General information

NPI: 1811641731
Provider Name (Legal Business Name): ALIGN MEDICAL DME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2022
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17014 W BELL RD STE 103
SURPRISE AZ
85374-2479
US

IV. Provider business mailing address

17014 W BELL RD STE 103
SURPRISE AZ
85374-2479
US

V. Phone/Fax

Practice location:
  • Phone: 623-229-6193
  • Fax: 602-680-5161
Mailing address:
  • Phone: 623-229-6193
  • Fax: 602-680-5161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. JASON L HAWKINS
Title or Position: OWNER/ CHIROPRACTOR
Credential: DC
Phone: 623-383-0880