Provider Demographics
NPI:1699159301
Name:ACTIVERX AZ INC
Entity type:Organization
Organization Name:ACTIVERX AZ INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-277-8319
Mailing Address - Street 1:7331 E OSBORN RD
Mailing Address - Street 2:SUTE 410
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6450
Mailing Address - Country:US
Mailing Address - Phone:480-443-0409
Mailing Address - Fax:480-704-4763
Practice Address - Street 1:7331 E OSBORN RD
Practice Address - Street 2:SUTE 410
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6450
Practice Address - Country:US
Practice Address - Phone:480-443-0409
Practice Address - Fax:480-704-4763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty