Provider Demographics
NPI:1497788293
Name:GERIPRO, INC.
Entity Type:Organization
Organization Name:GERIPRO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-249-6800
Mailing Address - Street 1:14637 N CAVE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-4154
Mailing Address - Country:US
Mailing Address - Phone:602-249-6800
Mailing Address - Fax:602-249-6888
Practice Address - Street 1:14637 N CAVE CREEK RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-4154
Practice Address - Country:US
Practice Address - Phone:602-249-6800
Practice Address - Fax:602-249-6888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ102591Medicaid
0298940001Medicare NSC