Organization
FOUR PEAKS MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA RAY GRASSER (PRESIDENT)
(602) 684-9537
Entity
Organization
Contact information
Practice address
1121 E MISSOURI AVE, SUITE 101, PHOENIX, AZ 85014-2713
(602) 684-9537
Mailing address
PO BOX 44441, PHOENIX, AZ 85064-4441
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
07/14/2014
Last updated
07/14/2014
Update your record
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