Provider Demographics
NPI:1891185682
Name:DESERT OPS LLC
Entity Type:Organization
Organization Name:DESERT OPS LLC
Other - Org Name:101 MOBILITY PHOENIX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:NAOMI
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-458-0791
Mailing Address - Street 1:6505 W FRYE RD
Mailing Address - Street 2:STE 24
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-3330
Mailing Address - Country:US
Mailing Address - Phone:480-553-7029
Mailing Address - Fax:480-553-7029
Practice Address - Street 1:6505 W FRYE RD
Practice Address - Street 2:STE 24
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-3330
Practice Address - Country:US
Practice Address - Phone:480-553-7029
Practice Address - Fax:480-553-7029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-31
Last Update Date:2015-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ21049830332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies