| Aim Healthcare Providers Mt, Pllc | |
|
161 E Rivulon Blvd Ste 210 Gilbert AZ 85297-0087 | |
| (480) 494-2465 | |
| Not Available |
| Full Name | Aim Healthcare Providers Mt, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 161 E Rivulon Blvd Ste 210, Gilbert, Arizona |
| Authorized Official Name and Position | Kelly A Karaniuk (CREDENTIALING DIRECTOR) |
| Authorized Official Contact | 4804942465 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aim Healthcare Providers Mt, Pllc 161 E Rivulon Blvd Ste 210 Gilbert AZ 85297-0087 Ph: (480) 494-2465 | Aim Healthcare Providers Mt, Pllc 161 E Rivulon Blvd Ste 210 Gilbert AZ 85297-0087 Ph: (480) 494-2465 |
| NPI Number | 1851107312 |
|---|---|
| Provider Enumeration Date | 12/09/2024 |
| Last Update Date | 12/09/2024 |
| Medicare PECOS PAC ID | 1658809587 |
|---|---|
| Medicare Enrollment ID | O20250106003219 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851107312 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Marina A Rath |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710404199 PECOS PAC ID: 9537422290 Enrollment ID: I20180410001714 |
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