Organization
FITTINGS BY NICKIE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NICKIE A MILLER (OWNER PRESIDENT)
(623) 463-0474
Entity
Organization
Contact information
Practice address
5101 N 60TH DR, GLENDALE, AZ 85301
(623) 463-0474
(623) 930-6230
Mailing address
5101 N 60TH DR, GLENDALE, AZ 85301
(623) 463-0474
(623) 930-6230
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
07612426B
AZ
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20806
PRESBYTERIAN HC
NM
01
—
AZ0278230
BCBS
AZ
Enumeration date
04/17/2007
Last updated
07/07/2008
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