| Spirit Healthcare Llc | |
|
12333 W Desert Mirage Dr Peoria AZ 85383-3449 | |
| (602) 663-0945 | |
| Not Available |
| Full Name | Spirit Healthcare Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 12333 W Desert Mirage Dr, Peoria, Arizona |
| Authorized Official Name and Position | Laurel Sockrider (OWNER) |
| Authorized Official Contact | 6026630945 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Spirit Healthcare Llc 12333 W Desert Mirage Dr Peoria AZ 85383-3449 Ph: () - | Spirit Healthcare Llc 12333 W Desert Mirage Dr Peoria AZ 85383-3449 Ph: (602) 663-0945 |
| NPI Number | 1780382119 |
|---|---|
| Provider Enumeration Date | 02/15/2023 |
| Last Update Date | 10/20/2023 |
| Medicare PECOS PAC ID | 0345697231 |
|---|---|
| Medicare Enrollment ID | O20231115000647 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780382119 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Laurel Sockrider |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881132314 PECOS PAC ID: 0547547861 Enrollment ID: I20171218001400 |
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