1 SOURCE LABS AND MEDICAL SERVICES LLC (NPI# 1730708017) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730708017 |
| Entity Type | Organization |
| Organization Name | 1 SOURCE LABS AND MEDICAL SERVICES LLC |
| Practice Address |
2440 W Mission Ln Ste 5 Phoenix AZ 85021-2824 |
| Practice Telephone | 6232611716 |
| Practice Fax Number | 6233211569 |
| Mailing Telephone | 6232611716 |
| Mailing Fax Number | 6233211569 |
| Enumeration Date | 2020-04-16 |
| Last Update Date | 2020-04-16 |
| Authorized Official Name | MR. MANUEL ENRIQUE SALGADO (CEO) |
| Authorized Official Telephone | 6232611716 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305S00000X | Point of Service | Managed Care Organizations |
| Street Address |
2440 W MISSION LN STE 5 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85021-2824 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679173181 | Jill M Robinson | Social Worker | 8804 N. 23rd Ave, Bldg. A Ste. A01-a02, Phoenix, AZ 85021 | 2020-10-26 |
| 1528671013 | Sabrina Mcninch | Behavior Technician | 1200 W Dunlap Ave, Ste 100, Phoenix, AZ 85021 | 2020-08-25 |
| 1376169938 | Maricopa County Special Heallth Care District | Pharmacy | 2025 W Northern Ave, Phoenix, AZ 85021 | 2020-06-19 |
| 1841832664 | Madison Westby | Physical Therapist | 717 W Dunlap Ave # 100, Phoenix, AZ 85021 | 2019-10-14 |
| 1861967481 | Southwest Family Naturopathic Clinic Pllc | Naturopath | 1530 W Glendale Ave Suite 103, Phoenix, AZ 85021 | 2018-10-10 |
| 1184101461 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 8804 N 23rd Ave, Suite A01/a02, Phoenix, AZ 85021 | 2018-07-19 |
| 1568970150 | Alycia Ann Poloni | Occupational Therapist | 7129 N 23d Ave, Phoenix, AZ 85021 | 2018-01-17 |
| 1154839165 | Cyrus Professional Corporation | Dentist | 2401 W. Glendale Ave, Ste 102, Phoenix, AZ 85021 | 2018-01-12 |
| 1568980779 | Marla Jean Clay | Licensed Practical Nurse | 1717 W. Glendale Ave. Apt. 3011, Phoenix, AZ 85021 | 2017-09-07 |
| 1801325162 | Kaitlin King | Nurse Practitioner | 8824 N 9th Ave, Phoenix, AZ 85021 | 2017-06-08 |
| Find all providers in zip 85021 | ||||
| Taxonomy Code | 305S00000X |
| Grouping | Managed Care Organizations |
| Classification | Point of Service |
| This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912444977 | Equally One | Point of Service | 3102 N 39th Ave, Phoenix, AZ 85019-4102 | 2017-01-27 |
| 1144692872 | Solera Health, Inc. | Point of Service | 111 W Monroe St Ste 300, Phoenix, AZ 85003-1718 | 2015-10-21 |
| 1124407267 | Viridian Health Solutions, Inc | Point of Service | 22601 N 19th Ave, Suite 200, Phoenix, AZ 85027-1326 | 2015-05-21 |
| 1992114623 | Rite Aid Pharmacy, Inc. | Point of Service | 7509 N 35th Ave Ste 2, Phoenix, AZ 85051-7480 | 2014-08-06 |
| 1841458890 | Catalyst Chiropractic | Point of Service | 4730 E Warner Rd, Ste 4, Phoenix, AZ 85044-3320 | 2008-05-27 |
| 1518184340 | Avia Partners | Point of Service | 20427 N 27th Ave, Phoenix, AZ 85027-3241 | 2007-04-20 |
| 1033263694 | Chrysalis Shelter for Victims of Domestic Violence Inc | Point of Service | 2055 West Northern Avenue, Phoenix, AZ 85021-5157 | 2007-01-22 |
| 1972015105 | Beauticians On The Go, Pllc | Point of Service | 2390 E Camelback Rd Ste 130, Phoenix, AZ 85016-3449 | 2017-10-27 |
| 1699144857 | Kids Kare Pediatrics | Point of Service | 521 W Thomas Rd, Phoenix, AZ 85013-4240 | 2015-09-17 |
| 1447644711 | Elw Health Center LLC | Point of Service | 3202 E Greenway Rd Ste 1619, Phoenix, AZ 85032-4553 | 2015-03-25 |
| Find all providers in PHOENIX | ||||
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| 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.