Arizona Vascular Medical Equipment Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

07-631470-B Issued in AZ

Legal business name

ARIZONA VASCULAR MEDICAL EQUIPMENT INC.

Practice address

5432 E Southern Ave Ste 100
Mesa, AZ 85206-2772

Phone

(480) 854-1900

Fax

(480) 854-1088

NPI assigned

May 4, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Maria Ernestina Granillo

Title

Owner

Phone

(480) 854-1900

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554940800000",
    "number": "1891907747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 E SOUTHERN AVE",
            "address_2": "SUITE F2",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827626",
            "telephone_number": "480-854-1900",
            "fax_number": "480-854-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5432 E SOUTHERN AVE STE 100",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062772",
            "telephone_number": "480-854-1900",
            "fax_number": "480-854-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA VASCULAR MEDICAL EQUIPMENT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2019-04-11",
        "status": "A",
        "authorized_official_last_name": "GRANILLO",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "ERNESTINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-854-1900",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "07-631470-B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ BC/BS ID #",
            "identifier": "AZ0275360",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFICARE",
            "identifier": "AZ401480",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "82-80095",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "325036",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "AX4016",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. OF LABOR",
            "identifier": "241407700",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0005429096",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AZ0275360",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Durable Medical Equipment & Medical Supplies in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.