Grossman & Grossman, Ltd. | |
3420 S Mercy Rd Ste 109 Gilbert AZ 85297-0420 | |
(602) 468-2077 | |
Not Available |
Full Name | Grossman & Grossman, Ltd. |
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Speciality | Community/Behavioral Health |
Location | 3420 S Mercy Rd Ste 109, Gilbert, Arizona |
Authorized Official Name and Position | Phyllis A Grossman (ADMINISTRATIVE DIRECTOR) |
Authorized Official Contact | 6024106635 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Grossman & Grossman, Ltd. Po Box 14948 Scottsdale AZ 85267-4948 Ph: (602) 468-2077 | Grossman & Grossman, Ltd. 3420 S Mercy Rd Ste 109 Gilbert AZ 85297-0420 Ph: (602) 468-2077 |
NPI Number | 1851711840 |
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Provider Enumeration Date | 04/17/2014 |
Last Update Date | 08/11/2022 |
Certification Date | 08/11/2022 |
Medicare PECOS PAC ID | 3476718057 |
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Medicare Enrollment ID | O20120705000176 |
Identifier | Type | State | Issuer |
---|---|---|---|
1851711840 | NPI | - | NPPES |
913430 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | OTC5871 (Arizona) | Primary |
Provider Name | Ann M Guthery |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902897168 PECOS PAC ID: 4789720228 Enrollment ID: I20091014000082 |
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