MEDICARE: MEDCAP FAMILY HOLDINGS, P.C.

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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1336298140
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDCAP FAMILY HOLDINGS, P.C.

Provider Business Mailing Address
First Line	:	1300 S WATSON RD
Second Line	:	A114-203
City	:	BUCKEYE
State	:	AZ
Zip	:	85326-6264
Country	:	US
Telephone Number	:	623-866-3361
Fax Number	:

Provider Business Practice Location Address
First Line	:	20508 W DANIEL PL
Second Line	:
City	:	BUCKEYE
State	:	AZ
Zip	:	85396-3649
Country	:	US
Telephone Number	:	623-866-3361
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOEL PHILLIP MEDRANO
Credential	:	R.N., P.T.A.
Telephone Number	:	623-866-3361

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	08/22/2020

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