Provider Demographics
NPI:1932405719
Name:NORTHWEST ALLIED PHYSICIANS LLC
Entity Type:Organization
Organization Name:NORTHWEST ALLIED PHYSICIANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-892-9813
Mailing Address - Street 1:1521 E TANGERINE RD
Mailing Address - Street 2:SUITE 337
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85755-6225
Mailing Address - Country:US
Mailing Address - Phone:520-901-6380
Mailing Address - Fax:520-901-6381
Practice Address - Street 1:1521 E TANGERINE RD
Practice Address - Street 2:SUITE 337
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85755-6225
Practice Address - Country:US
Practice Address - Phone:520-901-6380
Practice Address - Fax:520-901-6381
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHWEST ALLIED PHYSICIANS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-27
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ41649332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ154037Medicaid
AZ154037Medicaid