MEDICARE: NEXACC 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	247200000X	Other Technician

General Provider Information

NPI Number	:	1346009156
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEXACC LLC

Provider Business Mailing Address
First Line	:	7321 S 15TH DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85041-6932
Country	:	US
Telephone Number	:	443-739-9197
Fax Number	:

Provider Business Practice Location Address
First Line	:	7321 S 15TH DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85041-6932
Country	:	US
Telephone Number	:	443-739-9197
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JULIUS NDAHIRO
Credential	:
Telephone Number	:	443-739-9197

Provider Enumeration Date	:	03/14/2024
Last Update Date	:	03/14/2024

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