National Provider Identifier Database

MOUNTAIN HEART CATH LAB
Ambulatory Surgical


Contact Information

MOUNTAIN HEART CATH LAB
2000 S THOMPSON ST
FLAGSTAFF, AZ86001-8759
Phone: 928-226-6400
Fax: 928-226-6411
Website:
Specialty Taxonomy Code
* Ambulatory Surgical 261QA1903X
Rehabilitation: Cardiac Facilities 261QR0404X

* Indicates primary specialty

NPI Profile & details for MOUNTAIN HEART CATH LAB

NPI Number 1194988824
Legal business name
LBN
MOUNTAIN HEART CATH LAB
Authorized official SUZANNE DUVAL - (CREDENTIALING)
Entity Organization
Organization subpart No
Enumeration date 07/02/2008
Last updated 04/07/2009 - About 17 years ago
Sole proprietor1 Not specified
Identifiers
  • AZ License #: 30420

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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