Vic the Picc Southwest, LLC

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN051974 Issued in AZ

Legal business name

VIC THE PICC SOUTHWEST, LLC

Practice address

301 W Indian School Rd
Phoenix, AZ 85013-3205

Phone

(480) 636-9005

NPI assigned

Nov 22, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Cary J Catron, RN

Title

Ceo/President

Phone

(209) 334-9400

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1290384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290384000000",
    "number": "1255633384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 S HAM LN STE D",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952423592",
            "telephone_number": "209-334-9400",
            "fax_number": "209-334-9402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W INDIAN SCHOOL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133205",
            "telephone_number": "480-636-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIC THE PICC SOUTHWEST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-22",
        "last_updated": "2010-11-22",
        "status": "A",
        "authorized_official_last_name": "CATRON",
        "authorized_official_first_name": "CARY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "209-334-9400",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN051974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Registered Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2010; 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.