Provider Demographics
NPI:1245389105
Name:STAT-MED, INC.
Entity Type:Organization
Organization Name:STAT-MED, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:S
Authorized Official - Last Name:TRAMMELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-434-4895
Mailing Address - Street 1:23606 N 19TH AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-0675
Mailing Address - Country:US
Mailing Address - Phone:623-434-4895
Mailing Address - Fax:623-594-3270
Practice Address - Street 1:23606 N 19TH AVE STE 2
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-0675
Practice Address - Country:US
Practice Address - Phone:623-434-4895
Practice Address - Fax:623-594-3270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ07681143-U332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVMW00016Medicaid
AZ538895Medicaid
AZ4769180002Medicare NSC