1306862255 NPI number — RM ALLIANCE FAMILY HEALTH CTR INC

Table of content: (NPI 1306862255)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306862255 NPI number — RM ALLIANCE FAMILY HEALTH CTR INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RM ALLIANCE FAMILY HEALTH CTR INC
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:
WAYNE L FINLEY MD
Provider Other Organization Name Type Code:
3
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:
1306862255
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
POC MANAGEMENT LLC
Provider Second Line Business Mailing Address:
3000 W WARNER AVE
Provider Business Mailing Address City Name:
SANTA ANA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92704
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13821 N 35TH DR STE 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85053-5541
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-866-2843
Provider Business Practice Location Address Fax Number:
602-866-2847
Provider Enumeration Date:
07/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FINLEY
Authorized Official First Name:
WAYNE
Authorized Official Middle Name:
Authorized Official Title or Position:
MD
Authorized Official Telephone Number:
602-866-2843

Provider Taxonomy Codes

  • Taxonomy code: 332900000X , with the licence number:  14434 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0353312 . This is a "OTHER ID NUMBER-COMMERCIAL NUMBER" identifier . This identifiers is of the category "OTHER".




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