Provider Demographics
NPI:1891033015
Name:AZ-ACUCARE LLC
Entity Type:Organization
Organization Name:AZ-ACUCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:STILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-240-8338
Mailing Address - Street 1:3207 W MORSE DR
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-1658
Mailing Address - Country:US
Mailing Address - Phone:609-240-8338
Mailing Address - Fax:
Practice Address - Street 1:3207 W MORSE DR
Practice Address - Street 2:
Practice Address - City:ANTHEM
Practice Address - State:AZ
Practice Address - Zip Code:85086-1658
Practice Address - Country:US
Practice Address - Phone:609-240-8338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-23
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty