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EMBRY RIDDLE WELLNESS CENTER NPI 1104166727


NPI Information

NPI: 1104166727
Provider Name: EMBRY RIDDLE WELLNESS CENTER
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
3700 WILLOW CREEK RD
PRESCOTT, AZ
ZIP 86301
Phone: (928) 777-6653
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EMBRY RIDDLE WELLNESS CENTER is a general practice in Prescott, AZ. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee EMBRY RIDDLE WELLNESS CENTER NPI is 1104166727. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3700 WILLOW CREEK RD
PRESCOTT, AZ
ZIP 86301-721
Phone: (928) 777-6653

The provider's authorized official is Sandra Palmer .
The authorized official title is Director and has the following contact phone number (928) 777-6653.

The enumeration date for this NPI number is 2/19/2013 and was last updated on 2/19/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208D00000XGeneral PracticeARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11730289380OTHERARIZONAELLEN BUNCH MD TYPE I NPI
21649376831OTHERARIZONAPETER POWERS MD TYPE I NPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.