Provider Demographics
NPI:1144793779
Name:P&R MEDICAL CENTER, LLC
Entity Type:Organization
Organization Name:P&R MEDICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGBEHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-530-3489
Mailing Address - Street 1:7629 E PINNACLE PEAK RD STE 118
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-6292
Mailing Address - Country:US
Mailing Address - Phone:480-530-3489
Mailing Address - Fax:480-530-3482
Practice Address - Street 1:7629 E PINNACLE PEAK RD STE 118
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-6292
Practice Address - Country:US
Practice Address - Phone:480-530-3489
Practice Address - Fax:480-530-3482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-07
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty