Organization
TOEDR1 LLC
Active
Other names
M BARRY ROSENTHAL DPM
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTIN BARRY ROSENTHAL DPM (OWNER)
(520) 299-9499
Entity
Organization
Contact information
Practice address
6548 E CARONDELET DR, TUCSON, AZ 85710-2117
(520) 293-6000
(520) 299-6571
Mailing address
6516 N VIA DIVINA, TUCSON, AZ 85750-0970
(520) 299-9499
(520) 299-6571
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
AR8108703
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1Z1517
HEALTH NET
AZ
05
—
700593 05
—
AZ
01
—
AZ0191700
BLUE CROSS BLUE SHIELD
AZ
01
—
TOEDR
TRICARE
AZ
Enumeration date
05/24/2010
Last updated
05/24/2010
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