Provider Demographics
NPI:1336298140
Name:MEDCAP FAMILY HOLDINGS, P.C.
Entity Type:Organization
Organization Name:MEDCAP FAMILY HOLDINGS, P.C.
Other - Org Name:MEDCAP REHAB & WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:PHILLIP
Authorized Official - Last Name:MEDRANO
Authorized Official - Suffix:
Authorized Official - Credentials:RN, PTA
Authorized Official - Phone:623-866-3361
Mailing Address - Street 1:1300 S WATSON RD
Mailing Address - Street 2:A114-203
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85326-6264
Mailing Address - Country:US
Mailing Address - Phone:623-866-3361
Mailing Address - Fax:
Practice Address - Street 1:20508 W DANIEL PL
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85396-3649
Practice Address - Country:US
Practice Address - Phone:623-866-3361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy