Organization
BEACON BIOMEDICAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FREDERICK RANDALL GRIMES MBA (CHIEF OPERATING OFFICER)
(480) 757-9037
Entity
Organization
Contact information
Practice address
275 N GATEWAY DR STE 149, PHOENIX, AZ 85034-1700
(480) 757-9037
Mailing address
275 N GATEWAY DR STE 149, PHOENIX, AZ 85034-1700
(480) 757-9037
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
03D2122615
AZ
Other
Enumeration date
03/16/2018
Last updated
03/16/2018
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