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General NPI Number Information
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NPI Number | 1114347119
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Entity Type | Organization
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Legal Business Name | THE EKG GROUP LLC
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Dates
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Enumeration Date | 04/17/2014
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Last Update Date | 07/03/2014
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Provider Practice Location Address
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Address Line | 14819 N CAVE CREEK RD SUITE 18
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City | PHOENIX
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State | AZ
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Zip | 85032-4909
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Country | US
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Telephone | 602-688-8648
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Fax | 602-218-4331
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Provider Business Mailing Address
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Address Line | 14819 N CAVE CREEK RD SUITE 18
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City | PHOENIX
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State | AZ
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Zip | 85032-4909
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Country | US
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Telephone | 602-688-8648
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Fax | 602-218-4331
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. KAREN WONG GARCIA
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Credential | RN
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Telephone | 602-617-6728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HHA6561
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License Number State | AZ
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