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
—
—
Other
Enumeration date
08/04/2006
Last updated
08/22/2020
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