SUPERSTITION VITALITY CENTER LLC NPI 1295495422

NPI Information

NPI: 1295495422
Provider Name: SUPERSTITION VITALITY CENTER LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 03D2263527

Address:
312 N ALMA SCHOOL RD STE 1
CHANDLER, AZ
ZIP 85224
Phone: (480) 490-1230
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SUPERSTITION VITALITY CENTER LLC is a primary care clinic center in Chandler, AZ. SUPERSTITION VITALITY CENTER LLC NPI is 1295495422. The provider is registered as an organization entity type.

The provider's business location address is:

312 N ALMA SCHOOL RD STE 1
CHANDLER, AZ
ZIP 85224-354
Phone: (480) 490-1230

The provider's authorized official is Jolene Thweatt .
The authorized official title is Primary Care Nurse Practitioner and has the following contact phone number (480) 490-1230.

The CLIA number assigned to this NPI record is 03D2263527 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/29/2021 and was last updated on 2/27/2022.

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	261QP2300X	Clinic/Center	Primary Care		NEBRASKA	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: 4/28/2024

NPI Synchronization or Removal

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