Red Mountain Interventional Center LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

RED MOUNTAIN INTERVENTIONAL CENTER LLC

Practice address

2745 S Alma School Rd Ste 3
Chandler, AZ 85286-4405

Phone

(480) 292-8542

Fax

(480) 292-8534

NPI assigned

Nov 24, 2017

Last updated

Jun 5, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Hamblen Dean Fuller

Title

Organizer

Phone

(602) 793-0310

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1511481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559692800000",
    "number": "1558875807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2745 S ALMA SCHOOL RD STE 3",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852864405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2745 S ALMA SCHOOL RD STE 3",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852864405",
            "telephone_number": "480-292-8542",
            "fax_number": "480-292-8534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED MOUNTAIN INTERVENTIONAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-24",
        "last_updated": "2019-06-05",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "HAMBLEN",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "ORGANIZER",
        "authorized_official_telephone_number": "602-793-0310"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Multi-Specialty Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; 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.