Neuragenex Llc | |
3570 S Val Vista Dr Ste 110 Gilbert AZ 85297-7327 | |
(480) 246-7353 | |
Not Available |
Full Name | Neuragenex Llc |
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Speciality | Pain Medicine |
Location | 3570 S Val Vista Dr Ste 110, Gilbert, Arizona |
Authorized Official Name and Position | Timothy A Hirst (OWNER, AUTHORIZED OFFICIAL) |
Authorized Official Contact | 4802467353 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Neuragenex Llc 3570 S Val Vista Dr Ste 110 Gilbert AZ 85297-7327 Ph: () - | Neuragenex Llc 3570 S Val Vista Dr Ste 110 Gilbert AZ 85297-7327 Ph: (480) 246-7353 |
NPI Number | 1790310761 |
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Provider Enumeration Date | 03/10/2020 |
Last Update Date | 03/10/2020 |
Medicare PECOS PAC ID | 8426488545 |
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Medicare Enrollment ID | O20200413003513 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790310761 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
208VP0000X | Pain Medicine - Pain Medicine | (* (Not Available)) | Primary |
Provider Name | Rosalind Robles Caumban |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1295292589 PECOS PAC ID: 0648506170 Enrollment ID: I20190808001277 |
Provider Name | Alex Ramey |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841839776 PECOS PAC ID: 8022448232 Enrollment ID: I20200430000291 |
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