# RED MOUNTAIN INTERVENTIONAL PAIN, LLC

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

## Provider details

- **NPI number:** 1962994822
- **Authorized official:** HAMBLEN DEAN FULLER (MANAGER)
- **Authorized official phone:** (602) 793-0310

## Contact information

- **Practice address:** 1831 E QUEEN CREEK RD, CHANDLER, AZ 85286-2019
- **Practice address phone:** (480) 292-8542
- **Practice address fax:** (480) 292-8534
- **Mailing address:** 1831 E QUEEN CREEK RD, CHANDLER, AZ 85286-2019
- **Mailing address phone:** (480) 292-8542
- **Mailing address fax:** (480) 292-8534

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/05/2018
- **Last updated:** 06/05/2018