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General NPI Number Information
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NPI Number | 1902808603
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Entity Type | Organization
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Legal Business Name | SOUTHWEST PERFUSION, INC.
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Dates
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Enumeration Date | 08/11/2005
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Last Update Date | 08/18/2009
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Provider Practice Location Address
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Address Line | 5801 S MCCLINTOCK DR
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City | TEMPE
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State | AZ
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Zip | 85283-6002
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Country | US
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Telephone | 480-777-0900
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Fax | 480-777-1345
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Provider Business Mailing Address
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Address Line | PO BOX 27588
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City | TEMPE
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State | AZ
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Zip | 85285-7588
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Country | US
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Telephone | 480-777-0900
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Fax | 480-777-1345
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Authorized Official
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Title or Position | SECRETARY
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Name | MRS. MISSY COLSON
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Credential |
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Telephone | 480-777-0900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 242T00000X
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Taxonomy Name | Perfusionist
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License Number |
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License Number State |
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