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15341 W Waddell Rd Ste B-107 Surprise AZ 85379-5169 | |
| (623) 226-8225 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Durable Medical Equipment & Medical Supplies |
| Location | 15341 W Waddell Rd Ste B-107, Surprise, Arizona |
| Authorized Official Name and Position | Michael Coniam (CEO) |
| Authorized Official Contact | 6025109838 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
10752 W Prickly Pear Trl Peoria AZ 85383-9691 Ph: () - | 15341 W Waddell Rd Ste B-107 Surprise AZ 85379-5169 Ph: (623) 226-8225 |
| NPI Number | 1730939919 |
|---|---|
| Provider Enumeration Date | 03/22/2024 |
| Last Update Date | 05/14/2024 |
| Medicare PECOS PAC ID | 0143763763 |
|---|---|
| Medicare Enrollment ID | O20240624001046 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730939919 | NPI | - | NPPES |
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