Clove Llc | |
10051 E Dynamite Blvd Ste 110 Scottsdale AZ 85262-5239 | |
(480) 473-7003 | |
(480) 473-4499 |
Full Name | Clove Llc |
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Speciality | Family Medicine |
Location | 10051 E Dynamite Blvd Ste 110, Scottsdale, Arizona |
Authorized Official Name and Position | Arnetta Blackwell (CEO) |
Authorized Official Contact | 4804737003 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Clove Llc 10051 E Dynamite Blvd Ste 110 Scottsdale AZ 85262-5239 Ph: (480) 473-7003 | Clove Llc 10051 E Dynamite Blvd Ste 110 Scottsdale AZ 85262-5239 Ph: (480) 473-7003 |
NPI Number | 1013491166 |
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Provider Enumeration Date | 09/24/2018 |
Last Update Date | 05/22/2023 |
Medicare PECOS PAC ID | 3577806314 |
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Medicare Enrollment ID | O20190520001788 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013491166 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Ida Crocker Sabbagh |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1396808432 PECOS PAC ID: 7113829102 Enrollment ID: I20040121000731 |
Provider Name | Linda L Motsch |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1689630402 PECOS PAC ID: 5799753588 Enrollment ID: I20040920000818 |
Provider Name | Karem Patricia Colindres |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1457598815 PECOS PAC ID: 0345480034 Enrollment ID: I20130628000779 |
Provider Name | Wendy Song |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1144660671 PECOS PAC ID: 5597050211 Enrollment ID: I20160819001543 |
Provider Name | Kendra L Carter |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1063898674 PECOS PAC ID: 1759691637 Enrollment ID: I20180423001111 |
Provider Name | Emily Geiser |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1134731144 PECOS PAC ID: 2365849742 Enrollment ID: I20210928001583 |
Provider Name | Alexis Story Hatch |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1427339167 PECOS PAC ID: 8527410281 Enrollment ID: I20240118000096 |
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