Provider Demographics
NPI:1164682472
Name:ENVITA MEDICAL CENTERS
Entity Type:Organization
Organization Name:ENVITA MEDICAL CENTERS
Other - Org Name:ENVITA NATURAL MEDICAL CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:ACCOUNTING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LACEY
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROBLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-569-2959
Mailing Address - Street 1:9343 E BAHIA DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-1559
Mailing Address - Country:US
Mailing Address - Phone:602-569-4144
Mailing Address - Fax:
Practice Address - Street 1:8759 E BELL RD
Practice Address - Street 2:BLDG G
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-1322
Practice Address - Country:US
Practice Address - Phone:602-569-4144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-10
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Single Specialty