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NPI Code Detail

MEDICARE: STATCLINIX PLC

MEDICARE: STATCLINIX PLC
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
1261QU0200XUrgent Care Clinic/CenterOTC 3606AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588761647
Entity Type Code : Organization
Provider Name (Legal Business Name) : STATCLINIX PLC
Provider Business Mailing Address
First Line : 1151 N GILBERT RD
Second Line :
City : MESA
State : AZ
Zip : 85203-5127
Country : US
Telephone Number : 480-682-4118
Fax Number : 480-295-3701
Provider Business Practice Location Address
First Line : 1151 N GILBERT RD
Second Line :
City : MESA
State : AZ
Zip : 85203-5127
Country : US
Telephone Number : 480-682-4118
Fax Number : 480-295-3701
Authorized Official
Title or Position : COO
Name : MRS. MARY MCGUIRE
Credential : MBA, RN
Telephone Number : 480-516-7058
Provider Enumeration Date : 09/20/2006
Last Update Date : 01/11/2011

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Directions to “STATCLINIX PLC ” Practice Location

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