Provider Demographics
NPI:1770688293
Name:HEALTH LOGIC EDUCATION SERVICES, LLC
Entity Type:Organization
Organization Name:HEALTH LOGIC EDUCATION SERVICES, LLC
Other - Org Name:HEALTHLOGIC MOBILE IMMUNIZATION CLINICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:ZORN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:602-685-1072
Mailing Address - Street 1:668 N 44TH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-6506
Mailing Address - Country:US
Mailing Address - Phone:602-685-1072
Mailing Address - Fax:602-685-1073
Practice Address - Street 1:668 N 44TH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-6506
Practice Address - Country:US
Practice Address - Phone:602-685-1072
Practice Address - Fax:602-685-1073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN076865163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ67161Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER