| Heartfit For Duty Llc | |
|
633 E Ray Rd Suite 101 Gilbert AZ 85296-4200 | |
| (480) 999-7911 | |
| (480) 499-5829 |
| Full Name | Heartfit For Duty Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 633 E Ray Rd, Gilbert, Arizona |
| Authorized Official Name and Position | Kepra L Jack (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 6024025090 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heartfit For Duty Llc 4192 E Palm Beach Dr Chandler AZ 85249-7398 Ph: (602) 402-5090 | Heartfit For Duty Llc 633 E Ray Rd Suite 101 Gilbert AZ 85296-4200 Ph: (480) 999-7911 |
| NPI Number | 1295009561 |
|---|---|
| Provider Enumeration Date | 03/02/2012 |
| Last Update Date | 04/02/2013 |
| Medicare PECOS PAC ID | 4385045699 |
|---|---|
| Medicare Enrollment ID | O20210624000481 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295009561 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363LA2200X | Nurse Practitioner - Adult Health | AP3059 (Arizona) | Secondary |
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