Provider Demographics
NPI:1750988952
Name:BLAST RESOLVE, LLC
Entity type:Organization
Organization Name:BLAST RESOLVE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AND PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MBA, MS
Authorized Official - Phone:520-260-8030
Mailing Address - Street 1:6929 N HAYDEN RD STE C4-160
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85250-7994
Mailing Address - Country:US
Mailing Address - Phone:520-260-8030
Mailing Address - Fax:520-825-8304
Practice Address - Street 1:6929 N HAYDEN RD STE C4-160
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85250-7994
Practice Address - Country:US
Practice Address - Phone:520-260-8030
Practice Address - Fax:520-825-8304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No341600000XTransportation ServicesAmbulance