Provider Demographics
NPI:1609180264
Name:FIBROMYALGIA CENTERS OF AMERICA
Entity Type:Organization
Organization Name:FIBROMYALGIA CENTERS OF AMERICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:SCHERF
Authorized Official - Suffix:
Authorized Official - Credentials:MDA CLT CLI CSO ERM
Authorized Official - Phone:623-606-7808
Mailing Address - Street 1:2390 N ALMA SCHOOL ROAD
Mailing Address - Street 2:SUITE 121
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-8004
Mailing Address - Country:US
Mailing Address - Phone:480-361-6804
Mailing Address - Fax:480-895-2914
Practice Address - Street 1:2390 N ALMA SCHOOL ROAD
Practice Address - Street 2:SUITE 121
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-8004
Practice Address - Country:US
Practice Address - Phone:480-361-6804
Practice Address - Fax:480-895-2914
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ZEN LASER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ035134171W00000X
AZ08-1051175F00000X
AZ605-4718247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty
No171W00000XOther Service ProvidersContractorGroup - Single Specialty
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty