Provider Demographics
NPI:1659646198
Name:CENTURY HEALTH LLC
Entity Type:Organization
Organization Name:CENTURY HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MAXON MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-633-0730
Mailing Address - Street 1:19820 N 7TH AVE
Mailing Address - Street 2:SUITE 230-H
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-4736
Mailing Address - Country:US
Mailing Address - Phone:602-633-0730
Mailing Address - Fax:
Practice Address - Street 1:19820 N 7TH AVE
Practice Address - Street 2:SUITE 230-H
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-4736
Practice Address - Country:US
Practice Address - Phone:602-633-0730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-16
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies