Organization
ARIZONA VASCULAR MEDICAL EQUIPMENT INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIA ERNESTINA GRANILLO (OWNER)
(480) 854-1900
Entity
Organization
Contact information
Practice address
5432 E SOUTHERN AVE STE 100, MESA, AZ 85206-2772
(480) 854-1900
(480) 854-1088
Mailing address
2600 E SOUTHERN AVE, SUITE F2, TEMPE, AZ 85282-7626
(480) 854-1900
(480) 854-1088
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
07-631470-B
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005429096
AETNA
AZ
01
—
241407700
DEPT. OF LABOR
AZ
05
—
325036
—
AZ
01
—
82-80095
UNITED HEALTHCARE
AZ
01
—
AX4016
HEALTH NET
AZ
01
—
AZ0275360
AZ BC/BS ID #
AZ
01
—
AZ401480
PACIFICARE
AZ
Enumeration date
05/04/2007
Last updated
04/11/2019
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