Provider Demographics
NPI:1659379899
Name:MEDICAL AID CORPORATION
Entity Type:Organization
Organization Name:MEDICAL AID CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER/SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCORMACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-830-7314
Mailing Address - Street 1:4711 E FALCON DR
Mailing Address - Street 2:STE 208
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85215-2593
Mailing Address - Country:US
Mailing Address - Phone:480-830-7314
Mailing Address - Fax:480-445-9948
Practice Address - Street 1:4711 E FALCON DR
Practice Address - Street 2:STE 208
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85215-2593
Practice Address - Country:US
Practice Address - Phone:480-830-7314
Practice Address - Fax:480-445-9948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ07-693941-E332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ911794Medicaid
AZ5337890001Medicare NSC