Provider Demographics
NPI:1275111767
Name:INTERNATIONAL CONSULTANTS LLC
Entity Type:Organization
Organization Name:INTERNATIONAL CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:MERINO PAYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-388-3793
Mailing Address - Street 1:POBOX 990 PMB 1372
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS
Mailing Address - State:AZ
Mailing Address - Zip Code:85349
Mailing Address - Country:US
Mailing Address - Phone:928-388-3793
Mailing Address - Fax:
Practice Address - Street 1:1776 E LOS OLIVOS DR
Practice Address - Street 2:
Practice Address - City:SAN LUIS
Practice Address - State:AZ
Practice Address - Zip Code:85336-0630
Practice Address - Country:US
Practice Address - Phone:928-388-3793
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
No251B00000XAgenciesCase Management
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No305S00000XManaged Care OrganizationsPoint of Service