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General NPI Number Information
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NPI Number | 1942512546
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Entity Type | Organization
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Legal Business Name | CANYON MEDICAL
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Dates
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Enumeration Date | 07/12/2010
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Last Update Date | 07/12/2010
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Provider Practice Location Address
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Address Line | 8140 E CACTUS RD 240
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-5268
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Country | US
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Telephone | 480-678-9049
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Fax | 480-314-1518
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Provider Business Mailing Address
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Address Line | 11890 N 103RD PL
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-5935
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Country | US
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Telephone | 480-678-9049
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Fax | 480-314-1518
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROY RONNEN MYERS
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Credential |
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Telephone | 480-678-9049
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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