Provider Demographics
NPI:1124662408
Name:RAYIOM HEALTH AND WELLNESS, INC
Entity type:Organization
Organization Name:RAYIOM HEALTH AND WELLNESS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:D
Authorized Official - Last Name:STEMBRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:BA, MED, RBT
Authorized Official - Phone:520-840-7325
Mailing Address - Street 1:11225 N 28TH DR STE A102-22
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-5606
Mailing Address - Country:US
Mailing Address - Phone:520-840-7325
Mailing Address - Fax:
Practice Address - Street 1:11225 N 28TH DR STE A102-22
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-5606
Practice Address - Country:US
Practice Address - Phone:520-840-7325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RAYIOM HEALTH AND WELLNESS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-10-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty