Provider Demographics
NPI:1669454989
Name:CASA MEDICAL, INC
Entity Type:Organization
Organization Name:CASA MEDICAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BOBBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-941-9493
Mailing Address - Street 1:6902 E CHAPARRAL RD
Mailing Address - Street 2:
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-7080
Mailing Address - Country:US
Mailing Address - Phone:480-941-9493
Mailing Address - Fax:480-941-9492
Practice Address - Street 1:6902 E CHAPARRAL RD
Practice Address - Street 2:
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253-7080
Practice Address - Country:US
Practice Address - Phone:480-941-9493
Practice Address - Fax:480-941-9492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME03051FMedicaid
AZ644204Medicaid
AZ4292440001Medicare ID - Type Unspecified