1003040148 NPI number — ARIZONA RESPIRATORY MEDICINE PC

Table of content: (NPI 1003040148)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003040148 NPI number — ARIZONA RESPIRATORY MEDICINE PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARIZONA RESPIRATORY MEDICINE PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003040148
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/10/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
290 S. ALMA SCHOOL RD.
Provider Second Line Business Mailing Address:
SUITE 11
Provider Business Mailing Address City Name:
CHANDLER
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85224-7631
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-759-1027
Provider Business Mailing Address Fax Number:
480-759-1031

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
290 S. ALMA SCHOOL RD.
Provider Second Line Business Practice Location Address:
SUITE 11
Provider Business Practice Location Address City Name:
CHANDLER
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85224-7631
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-759-1027
Provider Business Practice Location Address Fax Number:
480-759-1031
Provider Enumeration Date:
05/04/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KADIKAR
Authorized Official First Name:
ANITA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
480-759-1027

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X , with the licence number:  32085 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RP1001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 832669 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".