| Daisy Family Health, Llc | |
|
4150 W Peoria Ave Ste 121 Phoenix AZ 85029-3951 | |
| (602) 314-6960 | |
| Not Available |
| Full Name | Daisy Family Health, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4150 W Peoria Ave Ste 121, Phoenix, Arizona |
| Authorized Official Name and Position | Angela Venetta Davis (OWNER) |
| Authorized Official Contact | 6023146960 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Daisy Family Health, Llc 4150 W Peoria Ave Ste 121 Phoenix AZ 85029-3951 Ph: (602) 314-6960 | Daisy Family Health, Llc 4150 W Peoria Ave Ste 121 Phoenix AZ 85029-3951 Ph: (602) 314-6960 |
| NPI Number | 1023657772 |
|---|---|
| Provider Enumeration Date | 12/29/2019 |
| Last Update Date | 12/29/2019 |
| Medicare PECOS PAC ID | 9931530557 |
|---|---|
| Medicare Enrollment ID | O20200515001040 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023657772 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Angela V Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992296768 PECOS PAC ID: 4486990678 Enrollment ID: I20190109000728 |
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