INTEGRATED WELLNESS CLUB (NPI# 1811396757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811396757 |
| Entity Type | Organization |
| Organization Name | INTEGRATED WELLNESS CLUB |
| Practice Address |
1968 Mesquite Ave Lake Havasu City AZ 86403-5729 |
| Practice Telephone | 4807034227 |
| Mailing Telephone | 4807034227 |
| Enumeration Date | 2014-08-16 |
| Last Update Date | 2014-08-16 |
| Authorized Official Name | MR. RUSTOM ALI (MEMBER, LLC) |
| Authorized Official Telephone | 4807034227 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174H00000X | Health Educator | Other Service Providers |
| Street Address |
1968 MESQUITE AVE |
| City | LAKE HAVASU CITY |
| State | AZ |
| Zip Code | 86403-5729 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790190155 | Rustom Ali | Nutritionist | 1968 Mesquite Ave, Lake Havasu City, AZ 86403-5729 | 2014-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104479039 | Liska's Apothecary Shop, Inc. | Assisted Living Facility | 1840 Mesquite Ave., Ste. E, Lake Havasu City, AZ 86403 | 2019-07-19 |
| 1275033227 | Ayad Costy | Pharmacist | 75 North Lake Havasu City, Lake Havasu City, AZ 86403 | 2018-02-16 |
| 1942727250 | Ideal Health Care, L.L.C. | Prosthetic/Orthotic Supplier | 1675 Mesquite Ave Ste A, Lake Havasu City, AZ 86403 | 2017-08-28 |
| 1063965036 | Cerner Health Connections, Inc | Clinic/Center | 89 Civic Center Blvd, Lake Havasu City, AZ 86403 | 2016-07-26 |
| 1447643358 | Lundin Dental PC | Durable Medical Equipment & Medical Supplies | 1741 Mesquite Avenue Ste B 100, Lake Havasu City, AZ 86403 | 2015-03-17 |
| 1912301425 | Arizona Havasu Bdm Pak LLC | Dentist | 1799 North Kiowa Blvd, Unit 109, Lake Havasu, AZ 86403 | 2014-10-13 |
| 1386047850 | Emily E Vona | Nurse Practitioner | 84 Acoma Blvd N Ste 104, Lake Havasu City, AZ 86403 | 2014-09-29 |
| 1750700589 | Thomas Wennergren | Pharmacist | 25 S Lake Havasu Ave, Lake Havasu City, AZ 86403 | 2014-04-09 |
| 1285997460 | Jamie L Lemire | Pharmacist | 1980 Mcculloch Blvd, Lake Havasu City, AZ 86403 | 2012-06-21 |
| 1053694448 | Goodwill of Northern Arizona | Exclusive Provider Organization | 1990 Mcculloch Blvd North, Lake Havasu City, AZ 86403 | 2011-09-22 |
| Find all providers in zip 86403 | ||||
| Taxonomy Code | 174H00000X |
| Grouping | Other Service Providers |
| Classification | Health Educator |
| Health educators work in a variety of settings providing education to individuals or groups of individuals on healthy behaviors, wellness, and health-related topics with the goal of preventing diseases and health problems. Health educators generally require a bachelor’s degree and may receive additional training, such as through mentoring, internships, or volunteer work. |
| Notes: Source: National Uniform Claim Committee, 2009 [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285242552 | Integrative Healthcare Solutions | Health Educator | 5675 N Oracle Rd Ste 3201, Tucson, AZ 85704-3884 | 2020-07-22 |
| 1861010654 | Quincy Egwu | Health Educator | 2509 N 114th Ave, Avondale, AZ 85392-5034 | 2020-07-08 |
| 1801426721 | Fern L Blizzard | Health Educator | 1932 E Cliff Swallow Trl, Green Valley, AZ 85614-6026 | 2020-01-20 |
| 1801445853 | Lisa Noble | Health Educator | 2711 E Schiliro Cir, Phoenix, AZ 85032-2453 | 2019-09-11 |
| 1982253795 | Anna Theresa Rueb | Health Educator | 5409 W Straight Arrow Ln, Phoenix, AZ 85083-9308 | 2019-09-05 |
| 1740841717 | Weight Watchers of Arizona, LLC | Health Educator | 4201 N 24th St Ste 240, Phoenix, AZ 85016-6267 | 2019-06-21 |
| 1821556333 | Gem Academy LLC | Health Educator | 11437 N 53rd Pl, Scottsdale, AZ 85254-4705 | 2019-03-05 |
| 1316422900 | Amy Rosner | Health Educator | 10914 E Tarragon Ave, Mesa, AZ 85212-5409 | 2018-09-28 |
| 1689190530 | Tara Shenai Laurie | Health Educator | 4701 S Lakeshore Dr Ste 1, Tempe, AZ 85282-7169 | 2017-08-22 |
| 1639693831 | Anthony Kafui Akator | Health Educator | 4131 E 5th St, Tucson, AZ 85711-1941 | 2017-07-28 |
| Find all providers with the same taxonomy | ||||
| City | LAKE HAVASU CITY |
| Zip Code | 86403 |
Please comment or provide details below to improve the information on INTEGRATED WELLNESS CLUB.
| 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.