Provider Demographics
NPI:1700303203
Name:RESTASSURED RX
Entity Type:Organization
Organization Name:RESTASSURED RX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:N
Authorized Official - Last Name:BOEHLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-552-9912
Mailing Address - Street 1:2423 W DUNLAP AVE STE 175
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-5823
Mailing Address - Country:US
Mailing Address - Phone:602-424-4450
Mailing Address - Fax:602-424-4451
Practice Address - Street 1:2423 W DUNLAP AVE STE 150
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-5818
Practice Address - Country:US
Practice Address - Phone:480-552-9912
Practice Address - Fax:888-898-5743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-25
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center