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General NPI Number Information
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NPI Number | 1437515293
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Entity Type | Organization
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Legal Business Name | DYNAMIC DURABLE MEDICAL EQUIPMENT LLC
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Dates
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Enumeration Date | 01/10/2016
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Last Update Date | 07/27/2016
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Provider Practice Location Address
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Address Line | 5900 N GRANITE REEF RD SUITE 107
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City | SCOTTSDALE
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State | AZ
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Zip | 85250-6279
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Country | US
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Telephone | 480-248-8006
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Fax | 888-796-1832
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Provider Business Mailing Address
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Address Line | 5900 N GRANITE REEF RD SUITE 107
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City | SCOTTSDALE
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State | AZ
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Zip | 85250-6279
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Country | US
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Telephone | 480-248-8006
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Fax | 888-796-1832
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Authorized Official
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Title or Position | OWNER
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Name | MR. ROBERT VAUGHT
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Credential |
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Telephone | 480-708-2681
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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