NPI 1720480940

Above and Beyond Care Providers

Organisation Exclusive Provider Organization Phoenix, AZ

Practice location

Address: 2136 E. Bowker St, Phoenix, AZ 85040
Phone: (702) 994-2611
Mailing address: 2308 E. Chipman Rd, Phoenix, AZ 85040

Authorised official

Name: Mercedes Kenisha Ward
Title: Owner
Phone: (702) 994-2611

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 302F00000X (AZ)

Other Exclusive Provider Organization providers in Arizona →

Registry record

NPI: 1720480940
Entity type: Organization
NPI issued: 18 Sep 2014
Record last updated: 18 Sep 2014

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.