Provider Type Icon

HEART SHOP LLC NPI 1558997742


NPI Information

NPI: 1558997742
Provider Name: HEART SHOP, LLC
Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

CLIA Number: 03D2192886

Address:
242 WHIPPLE ST
PRESCOTT, AZ
ZIP 86301
Phone: (928) 708-9355
Get Directions

HEART SHOP, LLC is a cardiovascular disease internal medicine in Prescott, 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. HEART SHOP, LLC NPI is 1558997742. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

242 WHIPPLE ST
PRESCOTT, AZ
ZIP 86301-787
Phone: (928) 708-9355
Fax: (928) 778-0278

The provider's authorized official is Douglas Wayne Rothrock .
The authorized official title is Owner and has the following contact phone number (928) 708-9355.

The CLIA number assigned to this NPI record is 03D2192886 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/19/2020 and was last updated on 5/19/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RC0000XInternal MedicineCardiovascular DiseaseYes

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

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.