Provider Demographics
NPI:1437529815
Name:SIMONMED IMAGING
Entity Type:Organization
Organization Name:SIMONMED IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLAIM PROCESSOR
Authorized Official - Prefix:
Authorized Official - First Name:STACI
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-428-5720
Mailing Address - Street 1:6900 E CAMELBACK RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-2431
Mailing Address - Country:US
Mailing Address - Phone:480-428-5720
Mailing Address - Fax:602-302-5801
Practice Address - Street 1:6900 E CAMELBACK RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-2431
Practice Address - Country:US
Practice Address - Phone:480-428-5720
Practice Address - Fax:602-302-5801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-29
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory