Provider Demographics
NPI:1295558922
Name:PARAGON BILLING LC
Entity type:Organization
Organization Name:PARAGON BILLING LC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:KIBUKAMUSOKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-359-1706
Mailing Address - Street 1:8805 W VAN BUREN ST UNIT 651
Mailing Address - Street 2:
Mailing Address - City:TOLLESON
Mailing Address - State:AZ
Mailing Address - Zip Code:85353-5127
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8805 W VAN BUREN ST UNIT 651
Practice Address - Street 2:
Practice Address - City:TOLLESON
Practice Address - State:AZ
Practice Address - Zip Code:85353-5127
Practice Address - Country:US
Practice Address - Phone:602-359-1706
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-01
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No305R00000XManaged Care OrganizationsPreferred Provider Organization