Provider Demographics
NPI:1023371622
Name:RHEUMATOLOGY & ARTHRITIS CONSULTANTS, PLLC
Entity Type:Organization
Organization Name:RHEUMATOLOGY & ARTHRITIS CONSULTANTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAJITHIA
Authorized Official - Middle Name:LALEENDRA
Authorized Official - Last Name:PREMARATNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-680-4255
Mailing Address - Street 1:1980 MESQUITE AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86403-7713
Mailing Address - Country:US
Mailing Address - Phone:928-680-4255
Mailing Address - Fax:928-680-4256
Practice Address - Street 1:1980 MESQUITE AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-7713
Practice Address - Country:US
Practice Address - Phone:928-680-4255
Practice Address - Fax:928-680-4256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty