| Healthy Life Family Medicine, Plc | |
|
750 N Estrella Pkwy Suite 40 Goodyear AZ 85338-9272 | |
| (602) 574-1890 | |
| Not Available |
| Full Name | Healthy Life Family Medicine, Plc |
|---|---|
| Speciality | Clinic/Center |
| Location | 750 N Estrella Pkwy, Goodyear, Arizona |
| Authorized Official Name and Position | John Monroe (CEO) |
| Authorized Official Contact | 6025741890 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthy Life Family Medicine, Plc Po Box 5204 Goodyear AZ 85338-0603 Ph: () - | Healthy Life Family Medicine, Plc 750 N Estrella Pkwy Suite 40 Goodyear AZ 85338-9272 Ph: (602) 574-1890 |
| NPI Number | 1750416400 |
|---|---|
| Provider Enumeration Date | 02/22/2007 |
| Last Update Date | 05/22/2019 |
| Medicare PECOS PAC ID | 4183717804 |
|---|---|
| Medicare Enrollment ID | O20070911000242 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750416400 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 35067 (Arizona) | Primary |
| Provider Name | John R Monroe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346312451 PECOS PAC ID: 4385741990 Enrollment ID: I20070516000144 |
| Provider Name | Christina M Martin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730318387 PECOS PAC ID: 1052563574 Enrollment ID: I20121210000050 |
| Provider Name | Jeremy Warren Ficken |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699164202 PECOS PAC ID: 1254647068 Enrollment ID: I20150824002435 |
| Provider Name | Natalie Joan Lake |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912062480 PECOS PAC ID: 6507020617 Enrollment ID: I20200326001231 |
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