Provider Demographics
NPI:1780428961
Name:REDEEMED HEALTHCARE, LLC
Entity type:Organization
Organization Name:REDEEMED HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:623-363-5480
Mailing Address - Street 1:5115 N DYSART RD
Mailing Address - Street 2:STE 202 #183
Mailing Address - City:LITCHFIELD PARL
Mailing Address - State:AZ
Mailing Address - Zip Code:85340
Mailing Address - Country:US
Mailing Address - Phone:623-363-5480
Mailing Address - Fax:
Practice Address - Street 1:20325 N 51ST AVE STE 154
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-4622
Practice Address - Country:US
Practice Address - Phone:623-363-5480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty