Basic Information
| Provider Information | |||||||||
| NPI: | 1851693527 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ANDOLORIS MEDICAL, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3417 N 32ND ST STE B | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850185606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8007224446 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10830 W ACACIA DR | ||||||||
| Address2: | |||||||||
| City: | SUN CITY | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85373 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2096323305 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/30/2010 | ||||||||
| LastUpdateDate: | 07/19/2018 | ||||||||
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| AuthorizedOfficialLastName: | SCHAMMEL | ||||||||
| AuthorizedOfficialFirstName: | SARI | ||||||||
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| AuthorizedOfficialTitleorPosition: | BILLER | ||||||||
| AuthorizedOfficialTelephone: | 8007224446 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.