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General NPI Number Information
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NPI Number | 1750403010
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Entity Type | Organization
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Legal Business Name | REM MEDICAL ARIZONA LLC
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Dates
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Enumeration Date | 04/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4545 E CHANDLER BLVD STE 202
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City | PHOENIX
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State | AZ
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Zip | 85048-7643
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Country | US
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Telephone | 480-991-0480
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6687
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City | MESA
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State | AZ
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Zip | 85216-6687
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ERIC PAGE
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Credential |
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Telephone | 480-991-0480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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