Providential Western Medical

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

PROVIDENTIAL WESTERN MEDICAL

Practice address

2202 E University Dr
Phoenix, AZ 85034-6840

Phone

(602) 257-9347

NPI assigned

Aug 4, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Stephanie Danielle Swinbourne

Title

Director of Information and Finance

Phone

(602) 744-2770

Specialties & licenses 1

Addresses

Other names 1

• Western Medical Former legal business name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043228919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 E UNIVERSITY DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850346840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 E UNIVERSITY DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850346840",
            "telephone_number": "602-257-9347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENTIAL WESTERN MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SWINBOURNE",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "DANIELLE",
        "authorized_official_title_or_position": "DIRECTOR OF INFORMATION AND FINANCE",
        "authorized_official_telephone_number": "602-744-2770",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Western Medical",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Oxygen Equipment & Supplies (DME) in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Oxygen Equipment & Supplies (DME) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.