Provider Demographics
NPI:1366714628
Name:AMERICAN PAIN SOLUTIONS OF ARIZONA, LLC
Entity type:Organization
Organization Name:AMERICAN PAIN SOLUTIONS OF ARIZONA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:HENSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-769-2774
Mailing Address - Street 1:4370 LA JOLLA VILLAGE DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-1249
Mailing Address - Country:US
Mailing Address - Phone:800-769-2774
Mailing Address - Fax:888-992-3532
Practice Address - Street 1:9023 E DESERT COVE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6714
Practice Address - Country:US
Practice Address - Phone:480-614-2774
Practice Address - Fax:480-614-2773
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERICAN PAIN SOLUTIONS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-02-02
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1075866261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center