Provider Demographics
NPI:1386475366
Name:VEROF INTEGRATED HEALTH SERVICES LLC
Entity type:Organization
Organization Name:VEROF INTEGRATED HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:O
Authorized Official - Last Name:SAMUEL-OJO
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:623-201-0084
Mailing Address - Street 1:8635 N 61ST DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85302-1374
Mailing Address - Country:US
Mailing Address - Phone:520-220-6704
Mailing Address - Fax:
Practice Address - Street 1:7142 N 57TH AVE STE 1
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-2555
Practice Address - Country:US
Practice Address - Phone:623-201-0084
Practice Address - Fax:623-444-9566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center