The Lodge At 14th St. | |
2941 N 14th St Phoenix AZ 85014-5604 | |
(602) 279-1033 | |
(602) 277-5604 |
Full Name | The Lodge At 14th St. |
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Speciality | Religious Nonmedical Health Care Institution |
Location | 2941 N 14th St, Phoenix, Arizona |
Authorized Official Name and Position | John Garvey (GENERAL PARTNER) |
Authorized Official Contact | 6022791033 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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The Lodge At 14th St. 2941 N. 14th St. Phoenix AZ 85014-5604 Ph: (602) 279-1033 | The Lodge At 14th St. 2941 N 14th St Phoenix AZ 85014-5604 Ph: (602) 279-1033 |
NPI Number | 1083698328 |
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Provider Enumeration Date | 11/30/2005 |
Last Update Date | 08/19/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083698328 | NPI | - | NPPES |
629256 | Medicaid | AZ | |
629-256 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | ALC 4746 (Arizona) | Secondary |
282J00000X | Religious Nonmedical Health Care Institution | ALC-4746 (Arizona) | Primary |
Richard A. Snider, Md, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12010 S Warner Elliot Loop, Phoenix, AZ 85044 Phone: 480-893-2644 | |
Kelly H. Roy, Md, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1008 E Mcdowell Rd, Phoenix, AZ 85006 Phone: 602-358-8588 Fax: 602-688-6991 | |
My Family Doctor In The Valley Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11030 N Tatum Blvd, Ste 101, Phoenix, AZ 85028 Phone: 602-687-8265 | |
Deborah L Dykema Do Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 20045 N 19th Ave Bldg 9-151, Phoenix, AZ 85027 Phone: 602-978-1555 | |
Scottsdale Housecall Physicians, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11030 N Tatum Blvd Ste 101, Phoenix, AZ 85028 Phone: 602-687-8265 | |
Wings Of Hope Medical Services, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11022 N 28th Dr Ste 205, Phoenix, AZ 85029 Phone: 602-971-0304 Fax: 602-971-0305 | |
Sheperd Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9150 W Indian School Rd Ste 111b, Phoenix, AZ 85037 Phone: 623-247-2300 Fax: 623-247-1939 |