MEDICARE: BUMBLEBEE HEALTH AFTER CARE 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	207QA0401X	Addiction Medicine (Family Medicine) Physician

General Provider Information

NPI Number	:	1841007176
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUMBLEBEE HEALTH AFTER CARE LLC

Provider Business Mailing Address
First Line	:	3101 N CENTRAL AVE STE 174
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85012-3613
Country	:	US
Telephone Number	:	480-652-9952
Fax Number	:

Provider Business Practice Location Address
First Line	:	3101 N CENTRAL AVE STE 174
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85012-3613
Country	:	US
Telephone Number	:	480-652-9952
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	STEPHEN WEIS
Credential	:
Telephone Number	:	480-652-9952

Provider Enumeration Date	:	12/11/2024
Last Update Date	:	12/11/2024

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