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General NPI Number Information
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NPI Number | 1326825092
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Entity Type | Organization
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Legal Business Name | ACTIVE VITAL CARE LLC
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Dates
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Enumeration Date | 09/14/2023
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 1928 E HIGHLAND AVE STE F104
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City | PHOENIX
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State | AZ
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Zip | 85016-4626
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Country | US
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Telephone | 833-242-0100
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Fax | 623-889-0814
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Provider Business Mailing Address
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Address Line | PO BOX 755
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City | SCOTTSDALE
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State | AZ
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Zip | 85252-0755
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Country | US
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Telephone | 833-242-0100
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Fax | 623-889-0814
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Authorized Official
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Title or Position | OWNER
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Name | DREW STURGIS
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Credential |
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Telephone | 661-644-1259
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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