Organization
AVESIS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L MOORE (REGULATORY LICENSE MANAGER)
(207) 356-4244
Entity
Organization
Contact information
Practice address
1275 W WASHINGTON ST STE 102, TEMPE, AZ 85288-1859
(800) 522-0258
Mailing address
1275 W WASHINGTON ST STE 102, TEMPE, AZ 85288-1859
(800) 522-0258
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
12/27/2011
Last updated
10/04/2023
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