Provider Demographics
NPI:1265219182
Name:MYMDPHONE HEALTHCARE SERVICES
Entity type:Organization
Organization Name:MYMDPHONE HEALTHCARE SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAJPAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:TOOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-419-4533
Mailing Address - Street 1:990 GREG KRUSCHEK AVENUE
Mailing Address - Street 2:APT 2A
Mailing Address - City:NOME
Mailing Address - State:AK
Mailing Address - Zip Code:99762
Mailing Address - Country:US
Mailing Address - Phone:929-955-6899
Mailing Address - Fax:
Practice Address - Street 1:990 GREG KRUSCHEK AVENUE
Practice Address - Street 2:APT 2A
Practice Address - City:NOME
Practice Address - State:AK
Practice Address - Zip Code:99762
Practice Address - Country:US
Practice Address - Phone:929-955-6899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-13
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility