Prestige Virtual Care Llc | |
10830 N 71st Pl Ste 105 Scottsdale AZ 85254-6105 | |
(480) 206-5619 | |
Not Available |
Full Name | Prestige Virtual Care Llc |
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Speciality | Family Medicine |
Location | 10830 N 71st Pl Ste 105, Scottsdale, Arizona |
Authorized Official Name and Position | Bryan Eugene Hooppaw (CEO) |
Authorized Official Contact | 4802065619 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Prestige Virtual Care Llc 10830 N 71st Pl Ste 105 Scottsdale AZ 85254-6105 Ph: () - | Prestige Virtual Care Llc 10830 N 71st Pl Ste 105 Scottsdale AZ 85254-6105 Ph: (480) 206-5619 |
NPI Number | 1548994072 |
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Provider Enumeration Date | 07/11/2022 |
Last Update Date | 05/01/2023 |
Medicare PECOS PAC ID | 0042683963 |
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Medicare Enrollment ID | O20230223002425 |
Identifier | Type | State | Issuer |
---|---|---|---|
1548994072 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
Provider Name | Susan Murphy |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1205239324 PECOS PAC ID: 3678877875 Enrollment ID: I20160215002654 |
Provider Name | Richard V Romero |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679032577 PECOS PAC ID: 4486983582 Enrollment ID: I20190916002451 |
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