Provider Demographics
NPI:1386095925
Name:PARKER EMERGENCY SERVICES LLC
Entity type:Organization
Organization Name:PARKER EMERGENCY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:C
Authorized Official - Last Name:RICHEMONT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-344-5550
Mailing Address - Street 1:PO BOX 3008
Mailing Address - Street 2:
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-7008
Mailing Address - Country:US
Mailing Address - Phone:626-447-0296
Mailing Address - Fax:
Practice Address - Street 1:1200 W MOHAVE RD
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:AZ
Practice Address - Zip Code:85344-6349
Practice Address - Country:US
Practice Address - Phone:928-669-9201
Practice Address - Fax:928-669-7422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-24
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty