MEDICARE: EVEREST MEDICAL SOLUTIONS, 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	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1467397992
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVEREST MEDICAL SOLUTIONS, LLC

Provider Business Mailing Address
First Line	:	2828 N CENTRAL AVE STE 710
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85004-1024
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2828 N CENTRAL AVE STE 710
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85004-1024
Country	:	US
Telephone Number	:	207-518-0023
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	ACHILLE MICHEL ROB RUGEMA
Credential	:
Telephone Number	:	207-518-0023

Provider Enumeration Date	:	04/21/2026
Last Update Date	:	04/21/2026

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