National Provider Identifier Database

PONDEROSA FAMILY CARE LLC
Rural Health


Contact Information

PONDEROSA FAMILY CARE, LLC
127 E MAIN ST STE D
PAYSON, AZ85541-5646
Phone: 928-468-8603
Fax: 928-468-8625
Website:
Specialty Taxonomy Code
* Rural Health 261QR1300X

* Indicates primary specialty

NPI Profile & details for PONDEROSA FAMILY CARE, LLC

NPI Number 1992321723
Legal business name
LBN
PONDEROSA FAMILY CARE, LLC
Authorized official ALAN MICHELS - (PHYSICIAN/OWNER)
Entity Organization
Organization subpart No
Enumeration date 06/17/2020
Last updated 06/17/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers n/a

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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