East Valley Serenity Health, Llc | |
4001 E Baseline Rd Ste 104 Gilbert AZ 85234-2736 | |
(480) 770-4540 | |
Not Available |
Full Name | East Valley Serenity Health, Llc |
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Speciality | General Practice |
Location | 4001 E Baseline Rd Ste 104, Gilbert, Arizona |
Authorized Official Name and Position | Ginni Orava (OWNER) |
Authorized Official Contact | 4807704540 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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East Valley Serenity Health, Llc 7030 S Star Dr Gilbert AZ 85298-4126 Ph: (480) 770-4540 | East Valley Serenity Health, Llc 4001 E Baseline Rd Ste 104 Gilbert AZ 85234-2736 Ph: (480) 770-4540 |
NPI Number | 1013475854 |
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Provider Enumeration Date | 03/11/2019 |
Last Update Date | 03/11/2020 |
Medicare PECOS PAC ID | 4981945987 |
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Medicare Enrollment ID | O20190329002423 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013475854 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Ginni M Orava |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619132479 PECOS PAC ID: 8022185255 Enrollment ID: I20080930000260 |
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