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General NPI Number Information
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NPI Number | 1902057748
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Entity Type | Organization
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Legal Business Name | H.O.A.N.J., LLC
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Dates
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Enumeration Date | 10/09/2008
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Last Update Date | 10/09/2008
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Provider Practice Location Address
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Address Line | 4263 HWY 68 SUITE C
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City | GOLDEN VALLEY
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State | AZ
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Zip | 86413-8569
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Country | US
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Telephone | 928-565-3939
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Fax | 877-684-3045
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Provider Business Mailing Address
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Address Line | 3990 STOCKTON HILL RD SUITE F 368
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City | KINGMAN
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State | AZ
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Zip | 86409-3024
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Country | US
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Telephone | 928-565-3939
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Fax | 877-684-3045
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Authorized Official
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Title or Position | BILLER
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Name | MS. TANYA M PECK
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Credential |
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Telephone | 928-753-1191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 35245
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License Number State | AZ
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