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Organization
VIC THE PICC SOUTHWEST, LLC
Active
Organization
VIC THE PICC SOUTHWEST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARY J CATRON RN (CEO/PRESIDENT)
(209) 334-9400
Entity
Organization
Contact information
Practice address
301 W INDIAN SCHOOL RD, PHOENIX, AZ 85013-3205
(480) 636-9005
Mailing address
777 S HAM LN STE D, LODI, CA 95242-3592
(209) 334-9400
(209) 334-9402
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN051974
AZ
Other
Enumeration date
11/22/2010
Last updated
11/22/2010
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