19TH AVENUE CLINIC LLC; NPI #1053667709

Contact Information

19TH AVENUE CLINIC LLC

835 W UNIVERSITY DR
MESA, AZ 85201-5555

Phone: 480-664-6007
Fax: 480-664-6017
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Urgent Care	261QU0200X

Indicates primary specialty

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NPI Profile & details for 19TH AVENUE CLINIC LLC

NPI Number	`1053667709`
LBN Legal business name	19TH AVENUE CLINIC LLC
Authorized official	RENEE BISKUPSKI - (VP OF OPERATIONS)
Entity	Organization
Organization subpart ¹	No
Enumeration date	07/31/2012
Last updated	07/31/2012 - About 14 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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