Provider Demographics
NPI:1902415011
Name:AIMSMEDAZ LLC
Entity Type:Organization
Organization Name:AIMSMEDAZ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLOSSOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-804-9007
Mailing Address - Street 1:PO BOX 768
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46546-0768
Mailing Address - Country:US
Mailing Address - Phone:574-804-9007
Mailing Address - Fax:
Practice Address - Street 1:1346 E MCDOWELL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2616
Practice Address - Country:US
Practice Address - Phone:574-804-9007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-24
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty