Provider Demographics
NPI:1114033479
Name:OHANESYAN SALMAS, ARMIK
Entity Type:Individual
Prefix:MR
First Name:ARMIK
Middle Name:
Last Name:OHANESYAN SALMAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1233 N MAIN ST
Mailing Address - Street 2:STE 4 P.O. BOX 11341
Mailing Address - City:SAN LUIS
Mailing Address - State:AZ
Mailing Address - Zip Code:85349
Mailing Address - Country:US
Mailing Address - Phone:928-722-0014
Mailing Address - Fax:928-722-6722
Practice Address - Street 1:1233 N MAIN ST
Practice Address - Street 2:STE 4
Practice Address - City:SAN LUIS
Practice Address - State:AZ
Practice Address - Zip Code:85349
Practice Address - Country:US
Practice Address - Phone:928-722-0014
Practice Address - Fax:928-722-6722
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ332B00000X332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies