Provider Demographics
NPI:1174490767
Name:RED ARROW MEDICAL LLC
Entity type:Organization
Organization Name:RED ARROW MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LIMY
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDUS
Authorized Official - Suffix:
Authorized Official - Credentials:CNP
Authorized Official - Phone:817-789-3721
Mailing Address - Street 1:4611 E CHANDLER BLVD STE 112-1188
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-0441
Mailing Address - Country:US
Mailing Address - Phone:817-789-3721
Mailing Address - Fax:
Practice Address - Street 1:8914 N 91ST AVE STE 105
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85345-8390
Practice Address - Country:US
Practice Address - Phone:817-789-3721
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RED ARROW HOLDINGS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-10-20
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty