Pectus Services of Arizona, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

PECTUS SERVICES OF ARIZONA, LLC

Practice address

3420 E Shea Blvd
Suite 213
Phoenix, AZ 85028-3345

Phone

(877) 732-8876

NPI assigned

Jun 11, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Joseph Porcello

Title

President/Owner

Phone

(877) 732-8876

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1402444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402444800000",
    "number": "1053725689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BODNAR ST",
            "city": "BERNARDSVILLE",
            "state": "NJ",
            "postal_code": "079241822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 E SHEA BLVD",
            "address_2": "SUITE 213",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850283345",
            "telephone_number": "877-732-8876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PECTUS SERVICES OF ARIZONA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-11",
        "last_updated": "2014-06-11",
        "status": "A",
        "authorized_official_last_name": "PORCELLO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "877-732-8876",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mischa Cohen Peck, MA, MSW, PHD, LCSW
• Barbara S Peckham-Devine, C.N.M.
• Jonathan Dale Peckham
• Dana Robin Peckman, LCSW
• Allison Marie Peckumn, D.O.
• Alexander Pedenko, M.D.
• Alexis Dianne Pedersen, PA C
• Jennifer Pedersen, CRNA
• Michelle Rose Pedersen, ACNP
• Ali Pederson, PHARM.D.

• Prosthetic/Orthotic Supplier in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Prosthetic/Orthotic Supplier in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2014; 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.