Ketamine Treatment Centers Of America is a
Nurse Practitioner - Family based in Phoenix, Arizona. Ketamine Treatment Centers Of America is licensed to practice in * (Not Available) (license number ) and their current practice location is
3201 W Peoria Ave Ste A105, Phoenix, Arizona. It can be reached at their office (for appointments etc.) via phone at
(480) 676-3555.
NPI number for Ketamine Treatment Centers Of America is 1720649064 and their current mailing address is 3201 W Peoria Ave Ste A105, Phoenix, Arizona. Ketamine Treatment Centers Of America
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1720649064.
Healthcare Provider's Profile
Full Name | Ketamine Treatment Centers Of America |
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Type | Facility |
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Speciality | Nurse Practitioner - Family |
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Location | 3201 W Peoria Ave Ste A105, Phoenix, Arizona |
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Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
NPI Data:
- NPI Number: 1720649064
- Provider Enumeration Date: 06/26/2019
- Last Update Date: 08/11/2019
Medical Identifiers
Medical identifiers for Ketamine Treatment Centers Of America such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1720649064 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
111NR0400X | Chiropractor - Rehabilitation | (* (Not Available)) | Secondary |
163WA0400X | Registered Nurse - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
163WI0500X | Registered Nurse - Infusion Therapy | (* (Not Available)) | Secondary |
163WP0000X | Registered Nurse - Pain Management | (* (Not Available)) | Secondary |
363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ketamine Treatment Centers Of America is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Ketamine Treatment Centers Of America 3201 W Peoria Ave Ste A105, Phoenix, AZ 85029-4609 Ph: (480) 676-3555 | Ketamine Treatment Centers Of America 3201 W Peoria Ave Ste A105, Phoenix, AZ 85029-4609 Ph: (480) 676-3555 |
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