Azsds LLC
Organization Active NPI Health Service Clinic/Center · Chandler, AZ
NPI 1760189310 · NPPES record last updated Apr 5, 2023
Key facts
- NPI
- 1760189310
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Health Service Clinic/Center 261QH0100X
- Legal business name
- AZSDS LLC
- Practice address
- 4960 W Ray Rd
Chandler, AZ 85226-6219 - Phone
- (480) 759-1668
- NPI assigned
- Feb 14, 2023
- Organization subpart
- No
Authorized official
- Name
- Dr. Eric Breure, DC
- Title
- Owner
- Phone
- (480) 265-5641
Practitioners 1
-
Eric C Breure, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240206001439 | AZ | Part B Supplier - Clinic/Group Practice | 9234572330 |
Receives reassigned benefits from 1 practitioner Practice locations: Chandler, AZ |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Service Clinic/Center | 261QH0100X | Yes |
Addresses
Primary practice location
4960 W Ray Rd
Chandler, AZ 85226-6219
Mailing address
924 N Sweetwater Bay Dr
Gilbert, AZ 85234-4983
Phone (480) 265-5643
Other names
- AZ SPINE DISC AND SPORT
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All providers in Chandler, AZ · Health Service Clinic/Center in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.