Provider Demographics
NPI:1306969761
Name:SPECTRUM HEALTH CARE, INC.
Entity type:Organization
Organization Name:SPECTRUM HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:S
Authorized Official - Last Name:LOCKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-464-8971
Mailing Address - Street 1:2143 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-3034
Mailing Address - Country:US
Mailing Address - Phone:480-464-8971
Mailing Address - Fax:480-464-0364
Practice Address - Street 1:2143 E 5TH ST
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-3034
Practice Address - Country:US
Practice Address - Phone:480-464-8971
Practice Address - Fax:480-464-0364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ03D0909740291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory