Organization
PLATINUM VENTURE GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEROME STARKS (CEO)
(801) 214-9918
Entity
Organization
Contact information
Practice address
7071 N 138TH AVE BLDG 1540, GLENDALE, AZ 85307-2006
(623) 248-4275
(623) 248-4273
Mailing address
848 E WOODOAK LN, MURRAY, UT 84107-6370
(623) 248-4275
(623) 248-4273
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/09/2019
Last updated
04/29/2021
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