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Contact Information

MEMD PROVIDER NETWORK LLC
6910 E CHAUNCEY LN STE 220
PHOENIX, AZ85054-5162
 Phone: 480-339-4573
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Urgent Care

261QU0200X
Indicates primary specialty

NPI Profile & details for MEMD PROVIDER NETWORK LLC

NPI Number 1376154625
LBN Legal business name MEMD PROVIDER NETWORK LLC
Authorized official GLENN DEAN - (CFO)
Entity Organization
Organization subpart 1 No
Enumeration date 08/11/2020
Last updated 09/22/2020 - About 6 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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