| Pure Healthcare Of Arizona Llc | |
|
1760 E Pecos Rd Ste 301 Gilbert AZ 85295-3203 | |
| (855) 550-3358 | |
| Not Available |
| Full Name | Pure Healthcare Of Arizona Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1760 E Pecos Rd Ste 301, Gilbert, Arizona |
| Authorized Official Name and Position | Joshua Tandy (DIRECTOR) |
| Authorized Official Contact | 8017870731 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pure Healthcare Of Arizona Llc 4179 S Riverboat Rd Ste 220 Taylorsville UT 84123-2986 Ph: (855) 550-3358 | Pure Healthcare Of Arizona Llc 1760 E Pecos Rd Ste 301 Gilbert AZ 85295-3203 Ph: (855) 550-3358 |
| NPI Number | 1619649076 |
|---|---|
| Provider Enumeration Date | 10/04/2021 |
| Last Update Date | 02/08/2024 |
| Medicare PECOS PAC ID | 0042602377 |
|---|---|
| Medicare Enrollment ID | O20220119001422 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619649076 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Jonathan M Baugh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578882759 PECOS PAC ID: 0244475333 Enrollment ID: I20140723002567 |
| Provider Name | Horng-chyi R Lai |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1528385598 PECOS PAC ID: 9133437817 Enrollment ID: I20220412001628 |
| Provider Name | Robert K Mannel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1093073181 PECOS PAC ID: 1658683073 Enrollment ID: I20240328002035 |
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