NPI 1043544802

Lets Be Pals LLC

Organisation Exclusive Provider Organization Mesa, AZ

Practice location

Address: 1101 S Sycamore 323, Mesa, AZ 85202-4005
Phone: (480) 497-3245
Mailing address: 1849 E Guadalupe Rd STE C101 166, Tempe, AZ 85283-3281

Authorised official

Name: Randolph Marshall Howard
Title: President
Phone: (480) 497-3245

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence L15454205 (AZ)

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Registry record

NPI: 1043544802
Entity type: Organization
NPI issued: 28 Sep 2009
Record last updated: 28 Sep 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.