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LIFETIME CARDIOVASCULAR PLC NPI 1114324837


NPI Information

NPI: 1114324837
Provider Name: LIFETIME CARDIOVASCULAR, PLC

Doing Business As: LIFETIME HEART AND VASCULAR

Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

CLIA Number: 03D2072427

Address:
3185 N WINDSONG DR
PRESCOTT VALLEY, AZ
ZIP 86314
Phone: (480) 699-5536
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LIFETIME CARDIOVASCULAR, PLC is a cardiovascular disease internal medicine in Prescott Valley, AZ. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. LIFETIME CARDIOVASCULAR, PLC NPI is 1114324837. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Lifetime Heart And Vascular.

The provider's business location address is:

3185 N WINDSONG DR
PRESCOTT VALLEY, AZ
ZIP 86314-240
Phone: (480) 699-5536
Fax: (480) 699-9283

The provider's authorized official is Gautam Kedia .
The authorized official title is Md and has the following contact phone number (480) 699-5536.

The CLIA number assigned to this NPI record is 03D2072427 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/24/2014 and was last updated on 11/24/2014.


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
1207RC0000XInternal MedicineCardiovascular DiseaseARIZONAYes

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
1Z164522MEDICARE PINARIZONA
2872220MEDICAIDARIZONA

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

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