MEDICARE: VALLEY OXIMETRY INCORPORATED

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	261QS1200X	Sleep Disorder Diagnostic Clinic/Center	OTC3511	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	319237	OTHER	AZ	AHCCCS ID
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	IZ9746	OTHER		HEALTHNET

General Provider Information

NPI Number	:	1700844610
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALLEY OXIMETRY INCORPORATED

Provider Business Mailing Address
First Line	:	PO BOX 30388
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85275-0388
Country	:	US
Telephone Number	:	480-830-3900
Fax Number	:	480-830-3901

Provider Business Practice Location Address
First Line	:	4555 E INVERNESS AVE
Second Line	:	BUILDING 3
City	:	MESA
State	:	AZ
Zip	:	85206-4630
Country	:	US
Telephone Number	:	480-830-3900
Fax Number	:	480-830-3901

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	MRS. LAURI L LEADLEY
Credential	:	RPSGT, RCP
Telephone Number	:	480-830-3900

Provider Enumeration Date	:	05/02/2006
Last Update Date	:	02/24/2017

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