Provider Demographics
NPI:1942916200
Name:ADULT MEDICAL CARE PLLC
Entity type:Organization
Organization Name:ADULT MEDICAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:480-264-0723
Mailing Address - Street 1:611 E MCKELLIPS RD
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85203-2534
Mailing Address - Country:US
Mailing Address - Phone:480-264-0723
Mailing Address - Fax:480-428-8678
Practice Address - Street 1:611 E MCKELLIPS RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-2534
Practice Address - Country:US
Practice Address - Phone:480-264-0723
Practice Address - Fax:480-428-8678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty