FREEDOM HEALTH INTERVENTIONAL CENTERS LLC NPI 1508364860

NPI Information

NPI: 1508364860
Provider Name: FREEDOM HEALTH INTERVENTIONAL CENTERS LLC
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 03D2194734

Address:
6036 N 19TH AVE STE 204
PHOENIX, AZ
ZIP 85015
Phone: (480) 626-1746
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FREEDOM HEALTH INTERVENTIONAL CENTERS LLC is a multi-specialty clinic center in Phoenix, AZ. FREEDOM HEALTH INTERVENTIONAL CENTERS LLC NPI is 1508364860. The provider is registered as an organization entity type.

The provider's business location address is:

6036 N 19TH AVE STE 204
PHOENIX, AZ
ZIP 85015-104
Phone: (480) 626-1746

The provider's authorized official is Andrew Doyle .
The authorized official title is Manager and has the following contact phone number (480) 626-1746.

The CLIA number assigned to this NPI record is 03D2194734 - other - outpatient lab with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 1/31/2018 and was last updated on 12/20/2023.

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	261QM1300X	Clinic/Center	Multi-Specialty			Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	433456	MEDICAID	ARIZONA

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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