BLU ADVOCATE PRIMARY CARE LLC


Address: 13029 W Vista Paseo Dr, Litchfield Park, AZ 85340-5572
Phone: 4803882988

BLU ADVOCATE PRIMARY CARE LLC (NPI# 1386269728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1386269728
Entity Type Organization
Organization Name BLU ADVOCATE PRIMARY CARE LLC
Practice Address 13029 W Vista Paseo Dr
Litchfield Park
AZ 85340-5572
Practice Telephone 4803882988
Mailing Telephone 4803882988
Enumeration Date 2020-06-11
Last Update Date 2020-09-15
Authorized Official Name MRS. WALKENNIA ELAINE SIMPSON EARL (PRIMARY CARE NP)
Authorized Official Telephone 4803882988
Authorized Official Credential AG-ANCP-BC
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QP2300X Clinic/Center
Specialization: Primary Care
Ambulatory Health Care Facilities

Office Location

Street Address 13029 W VISTA PASEO DR
City LITCHFIELD PARK
State AZ
Zip Code 85340-5572

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1992204614 Angelo J Maisano Occupational Therapy Assistant 4870 N Litchfield Road Suite #101, Litchfield Park, AZ 85340 2018-02-08
1114438645 Lori Ann Compiani Licensed Practical Nurse 272 E. Sagebrush St., Litchfield Park, AZ 85340 2017-10-24
1265972947 Christina Martinez Specialist/Technologist 4870 North Litchfield Rd #101, Litchfield Park, AZ 85340 2017-03-01
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Taxonomy Information

Taxonomy Code 261QP2300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Primary Care

Taxonomy Definition

Definition to come...

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Competitor

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City LITCHFIELD PARK
Zip Code 85340

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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