Provider Demographics
NPI:1487007498
Name:HRMC, LLC
Entity Type:Organization
Organization Name:HRMC, LLC
Other - Org Name:MOHAVE INFECTIOUS DISEASE & INTERNAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VP
Authorized Official - Prefix:
Authorized Official - First Name:JESS
Authorized Official - Middle Name:
Authorized Official - Last Name:JUDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-854-1242
Mailing Address - Street 1:1840 MESQUITE AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86403-5771
Mailing Address - Country:US
Mailing Address - Phone:928-854-1242
Mailing Address - Fax:928-854-1243
Practice Address - Street 1:1840 MESQUITE AVE
Practice Address - Street 2:SUITE G
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-5771
Practice Address - Country:US
Practice Address - Phone:928-854-1242
Practice Address - Fax:928-854-1243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-14
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3173207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ136916Medicare PIN