Desert Grove Family Medical

LBN: Heritage Technologies, Llc
Desert Grove Family Medical is an health care organization with primary practice located at 840 E Mckellips Rd Ste 101, Mesa AZ 85203-9645. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Heritage Technologies, Llc can be contacted via phone (480) 834-7546, or through Dinsdale, Michelle via phone (480) 834-7546.

Contact Information

Primary practice address
840 E Mckellips Rd Ste 101 Mesa AZ 85203-9645
Fax: (480) 834-8001
Website:
Authorized official contact:
Name: Dinsdale, Michelle

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1093764938
LBN Legal business name Heritage Technologies, Llc
DBA Doing business as Desert Grove Family Medical
Authorized official Dinsdale, Michelle
Entity Organization
Organization subpart 1 No
Enumeration date May 9th, 2006
Last updated May 16th, 2024 - about 4 months 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 1093764938 NPPES
Arizona MEDICAID 633795

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