Provider Demographics
NPI:1740514538
Name:HEALTH & PAIN CENTRE, LLC
Entity type:Organization
Organization Name:HEALTH & PAIN CENTRE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:STOTT
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:480-924-3200
Mailing Address - Street 1:7254 E SOUTHERN AVE.
Mailing Address - Street 2:#105
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-2787
Mailing Address - Country:US
Mailing Address - Phone:480-924-3200
Mailing Address - Fax:480-985-2546
Practice Address - Street 1:7254 E SOUTHERN AVE
Practice Address - Street 2:#105
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-2786
Practice Address - Country:US
Practice Address - Phone:480-924-3200
Practice Address - Fax:480-985-2546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-25
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8308208VP0000X
AZ#8308208VP0000X
AZRN082346363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZP36429Medicare UPIN
Z133186Medicare PIN