1811120827 NPI number — ADVANCED HEART AND VASCULAR INSTITUDE

Table of content: MS. TRACY ANN SCHIRM RN (NPI 1902508294)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811120827 NPI number — ADVANCED HEART AND VASCULAR INSTITUDE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED HEART AND VASCULAR INSTITUDE
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:
1811120827
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/25/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 80680
Provider Second Line Business Mailing Address:
190
Provider Business Mailing Address City Name:
PHOENIX
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85060-0680
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
602-507-6002
Provider Business Mailing Address Fax Number:
602-507-4339

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1331 N 7TH ST
Provider Second Line Business Practice Location Address:
190
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85006-2754
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-507-6002
Provider Business Practice Location Address Fax Number:
602-507-4339
Provider Enumeration Date:
08/25/2009

Additional Information

Authorized Official

Authorized Official Last Name:
ASSAR
Authorized Official First Name:
MANSOUR
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
602-507-6002

Provider Taxonomy Codes

  • Taxonomy code: 207RI0011X , with the licence number:  34004 , 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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