MEDICARE: RMD MEDICAL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician
2	207K00000X	Allergy & Immunology Physician

General Provider Information

NPI Number	:	1083178255
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RMD MEDICAL LLC

Provider Business Mailing Address
First Line	:	177 W COTTONWOOD LN STE 6
Second Line	:
City	:	CASA GRANDE
State	:	AZ
Zip	:	85122-2552
Country	:	US
Telephone Number	:	520-233-5905
Fax Number	:	520-233-5910

Provider Business Practice Location Address
First Line	:	177 W COTTONWOOD LN STE 6
Second Line	:
City	:	CASA GRANDE
State	:	AZ
Zip	:	85122-2552
Country	:	US
Telephone Number	:	520-233-5905
Fax Number	:	520-233-5910

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	JEFFREY D WOOLEY
Credential	:
Telephone Number	:	520-233-5905

Provider Enumeration Date	:	01/22/2019
Last Update Date	:	05/31/2022

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Directions to “RMD MEDICAL LLC ” Practice Location

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