1598164675 NPI number — FOCUS THERAPEUTICS, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598164675 NPI number — FOCUS THERAPEUTICS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FOCUS THERAPEUTICS, LLC
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:
1598164675
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/09/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 13581
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHANDLER
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85248-0044
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
443-310-2073
Provider Business Mailing Address Fax Number:
888-908-3581

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6835 EAST CAMELBACK ROAD
Provider Second Line Business Practice Location Address:
SUITE B13
Provider Business Practice Location Address City Name:
SCOTTSDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85251
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-310-2073
Provider Business Practice Location Address Fax Number:
888-908-3581
Provider Enumeration Date:
08/14/2014

Additional Information

Authorized Official

Authorized Official Last Name:
LINDSEY
Authorized Official First Name:
RAHSAAN
Authorized Official Middle Name:
LATEEF
Authorized Official Title or Position:
OWNER/MEDICAL DIRECTOR
Authorized Official Telephone Number:
443-310-2073

Provider Taxonomy Codes

  • Taxonomy code: 2084P0804X , with the licence number:  48549 , 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)





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