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General NPI Number Information
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NPI Number | 1922994631
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Entity Type | Organization
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Legal Business Name | KARUNA MEDX LLC
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Dates
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Enumeration Date | 06/17/2025
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 11640 N TATUM BLVD UNIT 2044
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City | PHOENIX
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State | AZ
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Zip | 85028-1686
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Country | US
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Telephone | 928-890-9670
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Fax |
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Provider Business Mailing Address
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Address Line | 1846 E INNOVATION PARK DR STE 100
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City | ORO VALLEY
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State | AZ
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Zip | 85755-1963
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Country | US
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Telephone | 928-890-9670
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN ASSISTANT
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Name | DRELAN CHE-STEWART FOWLER
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Credential | PA
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Telephone | 928-890-9670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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