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Geriatric Specialties of Arizona PC — NPI 1649690603, Phoenix, AZ | NPI Central

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NPI 1649690603

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Geriatric Specialties of Arizona PC

NPI 1649690603 · Non-Pharmacy Dispensing Site · Phoenix, AZ

Provider details

NPI number: 1649690603
Entity type: Organization
Primary specialty: Non-Pharmacy Dispensing SiteSuppliers
Parent organization: Medvantx, Inc.
Organization subpart: Yes
Authorized official: Kenny Heine, Vp of Operations(858) 964-1506
License: 19651 (AZ)

Specialties & taxonomies

Non-Pharmacy Dispensing SitePrimary332900000XLicense 19651 (AZ)
Suppliers

Practice location

6838 N 23rd Ave

Phoenix, AZ 85015-1056

Phone: (602) 864-8800

Approximate (ZIP-level) locationGet directions

More AZ providers

Mailing address

5626 Oberlin Dr

San Diego, CA 92121-1705

Other names (DBA / former)

Doing business as: Geriatric Specialties of Arizona

Registry dates

Enumerated: 2014-04-17
Last updated: 2014-11-10

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.