Provider Demographics
NPI:1316910789
Name:P AND T COMMITTEE, LLC
Entity type:Organization
Organization Name:P AND T COMMITTEE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:SMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-252-5000
Mailing Address - Street 1:1626 S EDWARD DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-6200
Mailing Address - Country:US
Mailing Address - Phone:602-252-5000
Mailing Address - Fax:602-323-5070
Practice Address - Street 1:1626 S EDWARD DR
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-6200
Practice Address - Country:US
Practice Address - Phone:602-252-5000
Practice Address - Fax:602-323-5070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-08
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ07552419B332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ345802-01Medicaid
AZ1072100001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER