Provider Demographics
NPI:1962267708
Name:DJLW HEALTH SERVICES INC.
Entity type:Organization
Organization Name:DJLW HEALTH SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-656-9177
Mailing Address - Street 1:3118 N 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-4107
Mailing Address - Country:US
Mailing Address - Phone:480-656-9177
Mailing Address - Fax:866-401-1401
Practice Address - Street 1:2425 S STEARMAN DR STE 110
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-5039
Practice Address - Country:US
Practice Address - Phone:480-656-9177
Practice Address - Fax:866-401-1404
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WHEELER MEDICAL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier