Provider Demographics
NPI:1659557114
Name:NUTRIHEALTH LLC
Entity Type:Organization
Organization Name:NUTRIHEALTH LLC
Other - Org Name:BRIMHALL WELLNES CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIMHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-964-5107
Mailing Address - Street 1:2323 E GUADALUPE RD STE 102
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-5008
Mailing Address - Country:US
Mailing Address - Phone:602-789-3440
Mailing Address - Fax:
Practice Address - Street 1:2323 E GUADALUPE RD STE 102
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-5008
Practice Address - Country:US
Practice Address - Phone:602-789-3440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-15
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZWCKJGMedicare PIN