NPIMap

Organization Active NPI

Stateserv Medical of Phoenix LLC

  • Durable Medical Equipment & Medical Supplies
  • Glendale, AZ
National Provider Identifier
1164051900
Registry record updated Apr 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
STATESERV MEDICAL OF PHOENIX LLC
Practice address
5234 W. Missouri
Glendale, AZ 85301
Phone
(877) 633-7250
NPI assigned
Apr 3, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2020

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

Authorized official

Name
Christopher Roode
Title
Coo
Phone
(877) 633-7250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

5234 W. Missouri
Glendale, AZ 85301

Mailing address

1201 South Alma School Rd
Suite 4000
Mesa, AZ 85210

National Provider Directory

National Provider Directory
Tax ID family
Stateserv Medical of Phoenix LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585872000000",
    "number": "1164051900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 SOUTH ALMA SCHOOL RD",
            "address_2": "SUITE 4000",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5234 W. MISSOURI",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85301",
            "telephone_number": "877-633-7250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATESERV MEDICAL OF PHOENIX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-03",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A",
        "authorized_official_last_name": "ROODE",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "877-633-7250"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.