Organization
PORTABLE X RAY OF ARIZONA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABBY GROSSA (CFO)
(702) 395-5011
Entity
Organization
Contact information
Practice address
2338 W ROYAL PALM RD, PHOENIX, AZ 85021-9339
(602) 864-3656
(602) 864-3660
Mailing address
5538 DUNCAN DR, LAS VEGAS, NV 89130-2812
(702) 395-5011
(702) 645-2874
Taxonomy
Speciality
Code
Description
License number
State
2085U0001X
Diagnostic Ultrasound Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2Z1598
HEALTH NET
AZ
01
—
579055
AHCCS
AZ
05
—
579055
—
AZ
01
—
67270
SCAN
AZ
01
—
AW2888
HEALTHNET
AZ
01
—
AZ0890990
BLUE CROSS BLUE SHILED OF
AZ
01
—
F10081
PHOENIX HEALTH PLAN
AZ
Enumeration date
03/13/2007
Last updated
11/15/2007
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us