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General NPI Number Information
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NPI Number | 1750988952
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Entity Type | Organization
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Legal Business Name | BLAST RESOLVE, LLC
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Dates
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Enumeration Date | 10/01/2020
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Last Update Date | 10/01/2020
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Provider Practice Location Address
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Address Line | 6929 N HAYDEN RD STE C4-160
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City | SCOTTSDALE
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State | AZ
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Zip | 85250-7994
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Country | US
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Telephone | 520-260-8030
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Fax | 520-825-8304
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Provider Business Mailing Address
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Address Line | 6929 N HAYDEN RD STE C4-160
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City | SCOTTSDALE
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State | AZ
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Zip | 85250-7994
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Country | US
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Telephone | 520-260-8030
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Fax | 520-825-8304
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Authorized Official
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Title or Position | CEO AND PRESIDENT
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Name | DR. STUART ALAN STEIN
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Credential | MD, MBA, MS
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Telephone | 520-260-8030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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