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Organization
PROVIDENTIAL WESTERN MEDICAL
Active
Organization
PROVIDENTIAL WESTERN MEDICAL
Active
Other names
Western Medical
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STEPHANIE DANIELLE SWINBOURNE (DIRECTOR OF INFORMATION AND FINANCE)
(602) 744-2770
Entity
Organization
Contact information
Practice address
2202 E UNIVERSITY DR, PHOENIX, AZ 85034-6840
(602) 257-9347
Mailing address
2202 E UNIVERSITY DR, PHOENIX, AZ 85034-6840
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
NULL
Other
Enumeration date
08/04/2006
Last updated
08/22/2020
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