# NOVASTACK LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316865561
- **Authorized official:** VIRGINIA BENTLEY (OWNER)
- **Authorized official phone:** (480) 210-2734

## Contact information

- **Practice address:** 4539 N 22ND ST STE R, PHOENIX, AZ 85016-4639
- **Practice address phone:** (480) 210-2734
- **Mailing address:** 4539 N 22ND ST STE R, PHOENIX, AZ 85016-4639
- **Mailing address phone:** (480) 210-2734

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/07/2026
- **Last updated:** 07/07/2026