INTEGRATED MEDICAL WELLNESS CENTER, LLC (NPI# 1194335802) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1194335802 |
Entity Type | Organization |
Organization Name | INTEGRATED MEDICAL WELLNESS CENTER, LLC |
Practice Address |
10184 W Happy Valley Pkwy Ste 180 Peoria AZ 85383-1254 |
Practice Telephone | 4802898464 |
Enumeration Date | 2020-08-06 |
Last Update Date | 2020-08-23 |
Authorized Official Name | ANDRE DREVAL (MANAGING MEMBER) |
Authorized Official Telephone | 6024002800 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
N | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities | ||
N | 207K00000X | Allergy & Immunology | Allopathic & Osteopathic Physicians | ||
N | 261QI0500X |
Clinic/Center Specialization: Infusion Therapy |
Ambulatory Health Care Facilities | ||
N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
Street Address |
10184 W HAPPY VALLEY PKWY STE 180 |
City | PEORIA |
State | AZ |
Zip Code | 85383-1254 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831701218 | West Point Optical Group | Optometrist | 24775 N. Pleasant Pkwy, Peoria, AZ 85383 | 2020-08-18 |
1528694247 | Lake Pleasant Kids Dentists and Orthodontics, LLP | Dentist | 24775 North Lake Pleasant Parkway Suite 104, Peoria, AZ 85383 | 2020-03-13 |
1124502273 | Nicole Angelina Hennigan | Registered Nurse | 9710 W. Happy Valley Rd, Suite 100 (salon 16), Peoria, AZ 85383 | 2018-09-24 |
1962994012 | Reach for The Stars Pediatric Therapy Pllc | Physical Therapy Assistant | 8662 W Lariat Ln, Peoria, AZ 85383 | 2018-06-05 |
1013417617 | Elite Infusions LLC | Internal Medicine | 10252 W Villa Chula, Peoria, AZ 85383 | 2018-02-20 |
1427577238 | Serene Valley Care LLC | Assisted Living Facility | 29751 N 119th Lane, Peoria, AZ 85383 | 2017-09-12 |
1255857827 | Advanced Air Amulance LLC | Ambulance | 9463 West El Cortez Place, Peoria, AZ 85383 | 2017-08-16 |
1427578996 | Paul R Arthur | Physical Therapist | 9745 W. Happy Valley Rd, Peoria, AZ 85383 | 2017-06-26 |
1528597143 | Lucy Denton | Specialist/Technologist | 9234 West Andrea Drive, Peoria, AZ 85383 | 2017-06-07 |
1801263579 | John Leano | Pharmacist | 26898 N 87th Dr, Peoria, AZ 85383 | 2015-08-28 |
Find all providers in zip 85383 |
Taxonomy Code | 261QM1300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Multi-Specialty |
Definition to come... |
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1750929949 | Banner Physician Specialists Arizona LLC | Clinic/Center | 9165 W Thunderbird Rd, Peoria, AZ 85381-4847 | 2019-12-18 |
1154822369 | Regenerative Foot & Ankle LLC | Clinic/Center | 13660 N 94th Dr Ste F1, Peoria, AZ 85381-4232 | 2018-02-22 |
1811220650 | Musculoskeletal Surgery Center, LLC | Clinic/Center | 303 N William Kumpf Blvd, Peoria, IL 61605-2507 | 2009-09-11 |
1992829485 | Cardinal Medical Group, Ltd. | Clinic/Center | 6339 N Big Hollow Rd, Peoria, IL 61615-2907 | 2007-03-19 |
1750347936 | Banner Arizona Medical Clinic Ltd | Clinic/Center | 13640 N Plaza Del Rio Blvd, Peoria, AZ 85381-4846 | 2006-04-25 |
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1689273542 | Orthopedic Specialists of North America Pllc | Clinic/Center | 33400 N 32nd Ave Fl 1, Phoenix, AZ 85085-8876 | 2020-10-21 |
1629676317 | Bethel Hills Integrated Healthcare | Clinic/Center | 13838 S 46th Pl Ste 300, Phoenix, AZ 85044-7804 | 2020-10-14 |
1639786585 | Crossover Health Medical Group | Clinic/Center | 1847 E Southern Ave Ste 3, Tempe, AZ 85282-5881 | 2020-09-24 |
1821605775 | Crossover Health Medical Group | Clinic/Center | 5251 W Campbell Ave Ste 200, Phoenix, AZ 85031-1719 | 2020-09-24 |
1649887597 | Crossover Health Medical Group | Clinic/Center | 8343 W Van Buren St Bldg C-2, Tolleson, AZ 85353-3225 | 2020-09-24 |
1235745464 | Vasco Healthcare Inc | Clinic/Center | 2110 W 24th St Ste A, Yuma, AZ 85364-8878 | 2020-09-22 |
1265048490 | Vasco Healthcare Inc | Clinic/Center | 8952 E Desert Cove Ave Ste 204, Scottsdale, AZ 85260-6777 | 2020-09-22 |
1942816160 | Vasco Healthcare Inc | Clinic/Center | 13026 W Rancho Santa Fe Blvd Ste B100, Avondale, AZ 85392-1712 | 2020-09-22 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.