Provider Demographics
NPI:1396623534
Name:AR CRANIAL PROTHESIS LLC
Entity type:Organization
Organization Name:AR CRANIAL PROTHESIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARNEICE
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-758-3332
Mailing Address - Street 1:2014 E SAINT CATHERINE AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85042-4667
Mailing Address - Country:US
Mailing Address - Phone:602-758-3332
Mailing Address - Fax:
Practice Address - Street 1:2014 E SAINT CATHERINE AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-4667
Practice Address - Country:US
Practice Address - Phone:602-758-3332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier