Provider Demographics
NPI:1992804371
Name:MOUNTAIN VIEW - CAMELBACK, LLC
Entity type:Organization
Organization Name:MOUNTAIN VIEW - CAMELBACK, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:HARSHBIR
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:CHHINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-836-0530
Mailing Address - Street 1:973 E COTTONWOOD LN
Mailing Address - Street 2:SUITE 105
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85222-2245
Mailing Address - Country:US
Mailing Address - Phone:520-836-0530
Mailing Address - Fax:520-876-0856
Practice Address - Street 1:973 E COTTONWOOD LN
Practice Address - Street 2:SUITE 105
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85222-2245
Practice Address - Country:US
Practice Address - Phone:520-836-0530
Practice Address - Fax:520-876-0856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5820920001Medicare NSC