Provider Demographics
NPI:1437342557
Name:MD ROOMSERVICE-DOCTORCARE
Entity Type:Organization
Organization Name:MD ROOMSERVICE-DOCTORCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-575-0576
Mailing Address - Street 1:PO BOX 7904
Mailing Address - Street 2:
Mailing Address - City:CAVE CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85327-7904
Mailing Address - Country:US
Mailing Address - Phone:480-575-0576
Mailing Address - Fax:480-575-0512
Practice Address - Street 1:7010 E ACOMA DR
Practice Address - Street 2:SUITE 102
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-3553
Practice Address - Country:US
Practice Address - Phone:480-575-0576
Practice Address - Fax:480-575-0512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ29916207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZF09622Medicare UPIN