VITALITY INTERNAL MEDICINE - GLENDALE LLC NPI 1336436690

NPI Information

NPI: 1336436690
Provider Name: VITALITY INTERNAL MEDICINE - GLENDALE LLC

Doing Business As: MENS VITALITY CENTER

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
18205 N 51ST AVE STE 129
GLENDALE, AZ
ZIP 85308
Phone: (623) 398-8554
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VITALITY INTERNAL MEDICINE - GLENDALE LLC is a primary care clinic center in Glendale, AZ. VITALITY INTERNAL MEDICINE - GLENDALE LLC NPI is 1336436690. The provider is registered as an organization entity type.
The provider Is Doing Business As Mens Vitality Center.

The provider's business location address is:

18205 N 51ST AVE STE 129
GLENDALE, AZ
ZIP 85308-492
Phone: (623) 398-8554

The provider's authorized official is Charles Benjamin Evans .
The authorized official title is Owner and has the following contact phone number (602) 791-9112.

The enumeration date for this NPI number is 7/6/2011 and was last updated on 7/6/2011.

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	37616	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: 4/28/2024

NPI Synchronization or Removal

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