| Kidney Care At Home Llc | |
|
1301 E Mcdowell Rd Phoenix AZ 85006-2621 | |
| (602) 962-0088 | |
| Not Available |
| Full Name | Kidney Care At Home Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1301 E Mcdowell Rd, Phoenix, Arizona |
| Authorized Official Name and Position | Anna Manalo (OWNER) |
| Authorized Official Contact | 6029620088 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kidney Care At Home Llc 1301 E Mcdowell Rd Phoenix AZ 85006-2621 Ph: () - | Kidney Care At Home Llc 1301 E Mcdowell Rd Phoenix AZ 85006-2621 Ph: (602) 962-0088 |
| NPI Number | 1205423530 |
|---|---|
| Provider Enumeration Date | 12/21/2020 |
| Last Update Date | 12/21/2020 |
| Medicare PECOS PAC ID | 5496160640 |
|---|---|
| Medicare Enrollment ID | O20210219002300 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205423530 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Anna D Manalo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609205350 PECOS PAC ID: 6305076951 Enrollment ID: I20140228000039 |
| Provider Name | Emilia Luisa Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285267237 PECOS PAC ID: 9638500879 Enrollment ID: I20200504001021 |
| Provider Name | Nerissa Apostol Zafe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275162323 PECOS PAC ID: 4981035151 Enrollment ID: I20200504002721 |
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