1649524968 NPI number — THEMA MANAGEMENT COMPANY

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 1649524968 NPI number — THEMA MANAGEMENT COMPANY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THEMA MANAGEMENT COMPANY
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:
6
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:
1649524968
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/08/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7500 N DREAMY DRAW DR
Provider Second Line Business Mailing Address:
SUITE 105A
Provider Business Mailing Address City Name:
PHOENIX
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85020-4660
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
602-889-4400
Provider Business Mailing Address Fax Number:
602-216-6112

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2123 SUNSET PT
Provider Second Line Business Practice Location Address:
SUITE B3
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85539-1347
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-425-8330
Provider Business Practice Location Address Fax Number:
928-425-8335
Provider Enumeration Date:
11/08/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LUNGWITZ
Authorized Official First Name:
THERESA
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
602-889-4400

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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