Provider Demographics
NPI:1003115817
Name:AZCNMT LLC
Entity Type:Organization
Organization Name:AZCNMT LLC
Other - Org Name:USA PRACTICE MANAGEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-389-4120
Mailing Address - Street 1:233 E SOUTHERN AVE
Mailing Address - Street 2:P.O. BOX 27841
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-5189
Mailing Address - Country:US
Mailing Address - Phone:480-389-4120
Mailing Address - Fax:
Practice Address - Street 1:2147 E OXFORD DR
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-2419
Practice Address - Country:US
Practice Address - Phone:480-389-4120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AZCNMT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-18
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile