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General NPI Number Information
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NPI Number | 1205573235
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Entity Type | Organization
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Legal Business Name | THRIVEWELL ARIZONA LLC
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Dates
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Enumeration Date | 05/20/2022
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Last Update Date | 05/20/2022
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Provider Practice Location Address
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Address Line | 8160 E BUTHERUS DR STE 9
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-2523
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Country | US
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Telephone | 480-695-8228
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Fax |
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Provider Business Mailing Address
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Address Line | 8160 E BUTHERUS DR STE 7
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-2523
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Country | US
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Telephone | 480-695-8228
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. JARED SIMMONS
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Credential |
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Telephone | 480-695-8228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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