1720319429 NPI number — VALLEY OXIMETRY INCORPORATED

Table of content: (NPI 1720319429)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720319429 NPI number — VALLEY OXIMETRY INCORPORATED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VALLEY OXIMETRY INCORPORATED
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:
VALLEY SLEEP CENTER
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:
1720319429
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/24/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 30388
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MESA
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85275-0388
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-830-3900
Provider Business Mailing Address Fax Number:
480-830-3901

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6320 W UNION HILLS DR
Provider Second Line Business Practice Location Address:
BUILDING B STE 1000
Provider Business Practice Location Address City Name:
GLENDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85308-1096
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-830-3900
Provider Business Practice Location Address Fax Number:
480-830-3901
Provider Enumeration Date:
01/19/2010

Additional Information

Authorized Official

Authorized Official Last Name:
LEADLEY
Authorized Official First Name:
LAURI
Authorized Official Middle Name:
L
Authorized Official Title or Position:
PRESIDENT & CEO
Authorized Official Telephone Number:
602-300-9158

Provider Taxonomy Codes

  • Taxonomy code: 261QS1200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 530196 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: AZ0278730 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 1Z9746 . This is a "HEALTHNET" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 319237 . This is a "AHCCCS ID" identifier , issued by the state of ( AK ) . This identifiers is of the category "OTHER".




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