Provider Demographics
NPI:1174264675
Name:ALPHAMED ARROWHEAD LLC
Entity Type:Organization
Organization Name:ALPHAMED ARROWHEAD LLC
Other - Org Name:ALPHAMED ARROWHEAD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CANTWELL
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:602-908-2025
Mailing Address - Street 1:20249 N 67TH AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-6843
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20249 N 67TH AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-6843
Practice Address - Country:US
Practice Address - Phone:623-250-4550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MADISON MEDICAL PARTNERS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-06
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty