Provider Demographics
NPI:1629238589
Name:WORLD INTEGRATED SYSTEMS IN HEALTH, LLC
Entity Type:Organization
Organization Name:WORLD INTEGRATED SYSTEMS IN HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BEVACQUA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:520-743-0575
Mailing Address - Street 1:4627 N 1ST AVE
Mailing Address - Street 2:SUITE #2
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-8606
Mailing Address - Country:US
Mailing Address - Phone:520-743-0575
Mailing Address - Fax:
Practice Address - Street 1:4627 N 1ST AVE
Practice Address - Street 2:SUITE #2
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-8606
Practice Address - Country:US
Practice Address - Phone:520-743-0575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty