ARIZONA MEDICAL BOUTIQUE LLC NPI 1548462716

NPI Information

NPI: 1548462716
Provider Name: ARIZONA MEDICAL BOUTIQUE, LLC
Classification: Public Health or Welfare - 251K00000X
Entity Type: Organization
Address:
35017 N 30TH DR
PHOENIX, AZ
ZIP 85086
Phone: (480) 766-0550
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ARIZONA MEDICAL BOUTIQUE, LLC is a public health or welfare in Phoenix, AZ. ARIZONA MEDICAL BOUTIQUE, LLC NPI is 1548462716. The provider is registered as an organization entity type.

The provider's business location address is:

35017 N 30TH DR
PHOENIX, AZ
ZIP 85086-224
Phone: (480) 766-0550
Fax: (623) 581-7499

The provider's authorized official is Shuree Kristine Oldehoeft .
The authorized official title is Physician Assistant and has the following contact phone number (480) 766-0550.

The enumeration date for this NPI number is 6/1/2007 and was last updated on 8/22/2020.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251K00000X	Public Health or Welfare		3164	ARIZONA	Yes

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: 11/14/2023

NPI Synchronization or Removal

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