Provider Demographics
NPI:1477888642
Name:RIGHTWAY HEALTHCARE LLC
Entity Type:Organization
Organization Name:RIGHTWAY HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:MAKI
Authorized Official - Suffix:
Authorized Official - Credentials:MPH, MBA
Authorized Official - Phone:623-877-5586
Mailing Address - Street 1:1864 E FLORENCE BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-5457
Mailing Address - Country:US
Mailing Address - Phone:520-876-5000
Mailing Address - Fax:623-877-9629
Practice Address - Street 1:1864 E FLORENCE BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122
Practice Address - Country:US
Practice Address - Phone:520-876-5000
Practice Address - Fax:623-877-9629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-06
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ31870207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ133231Medicare PIN
AZ033833Medicare Oscar/Certification