Organization
CANYON MEDICAL LOGISTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF BLAIR (AUTHORIZED REPRESENTATIVE)
(602) 492-8832
Entity
Organization
Contact information
Practice address
5060 N 19TH AVE STE 300, PHOENIX, AZ 85015-3213
(602) 492-8832
Mailing address
11201 N TATUM BLVD STE 300, PHOENIX, AZ 85028-6039
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
04/05/2023
Last updated
04/05/2023
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