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General NPI Number Information
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NPI Number | 1164009932
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Entity Type | Organization
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Legal Business Name | SIMPLICITY CARE ASSOCIATES LLC
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Dates
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Enumeration Date | 03/26/2021
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Last Update Date | 03/26/2021
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Provider Practice Location Address
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Address Line | 6424 E BROADWAY RD STE 102
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City | MESA
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State | AZ
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Zip | 85206-1750
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Country | US
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Telephone | 480-634-4606
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Fax |
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Provider Business Mailing Address
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Address Line | 6424 E BROADWAY RD STE 102
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City | MESA
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State | AZ
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Zip | 85206-1750
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Country | US
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Telephone | 480-634-4606
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | BRANDIE A HERNANDEZ
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Credential |
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Telephone | 480-634-4606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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