<Unavail>

LBN: Main Street Diagnostic Llc
<Unavail> is an health care organization with primary practice located at 636 N Main St , Cottonwood AZ 86326-3725. The organization recently has only one registered license in Hospitals / Psychiatric Hospital, which is considered as the primary health care specialty. Main Street Diagnostic Llc can be contacted via phone (928) 639-4440, or through Carrillo, Maria via phone (928) 639-4440.

Contact Information

Primary practice address
636 N Main St Cottonwood AZ 86326-3725
Phone: (928) 639-4440
Fax: (928) 639-3924
Website:
Map and Directions
Authorized official contact:
Name: Carrillo, Maria
Phone: (928) 639-4440

Health care specialties

SpecialtyCodeLicense #State
Hospitals / Psychiatric Hospital 283Q00000X BH-2492 Arizona

Profile Details

NPI number 1225027477
LBN Legal business name Main Street Diagnostic Llc
DBA Doing business as <Unavail>
Authorized official Carrillo, Maria
Entity Organization
Organization subpart 1 No
Enumeration date Oct 20th, 2005
Last updated Aug 22nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225027477 NPPES
Arizona Other 3955228 AETNA
Arizona Other 404204 AETNA
Arizona Other AZ0209640 AETNA
Arizona Other BH-2492 AETNA
Arizona Other 2215360 AETNA
Arizona MEDICAID 887317 AETNA
Arizona Other 100322 AETNA

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