Provider Demographics
NPI:1427812197
Name:PROSANO HEALTH SOLUTIONS, INC.
Entity type:Organization
Organization Name:PROSANO HEALTH SOLUTIONS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-493-7249
Mailing Address - Street 1:8220 N 23RD AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-4872
Mailing Address - Country:US
Mailing Address - Phone:480-240-3626
Mailing Address - Fax:
Practice Address - Street 1:19810 N 7TH AVE STE 150
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-4741
Practice Address - Country:US
Practice Address - Phone:855-776-7266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROSANO HEALTH SOLUTIONS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-12
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No3336C0002XSuppliersPharmacyClinic PharmacyGroup - Multi-Specialty