Healthcare Provider Details

I. General information

NPI: 1376947655
Provider Name (Legal Business Name): SNAPCARE CONVENIENCE HEALTHCARE CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2014
Last Update Date: 10/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 S RURAL RD STE 4N
TEMPE AZ
85282-2442
US

IV. Provider business mailing address

740 E HERMOSA DR
TEMPE AZ
85282-5351
US

V. Phone/Fax

Practice location:
  • Phone: 480-664-2753
  • Fax:
Mailing address:
  • Phone: 480-664-2753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CHALICE A BLINICK
Title or Position: MEMBER/OWNER
Credential: FNP-C
Phone: 480-664-2753