AGELESS NUTRITION BAR HOLDINGS INC NPI 1932704830

NPI Information

NPI: 1932704830
Provider Name: AGELESS NUTRITION BAR HOLDINGS, INC

Doing Business As: AGELESS MEN'S HEALTH

Classification: Family Medicine - 207QA0505X
Entity Type: Organization

Specialization: Adult Medicine

Address:
4802 E RAY RD # 9
PHOENIX, AZ
ZIP 85044
Phone: (901) 757-3643
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AGELESS NUTRITION BAR HOLDINGS, INC is an adult medicine family medicine in Phoenix, AZ. The provider is the National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code. AGELESS NUTRITION BAR HOLDINGS, INC NPI is 1932704830. The provider is registered as an organization entity type.
The provider Is Doing Business As Ageless Men's Health.

The provider's business location address is:

4802 E RAY RD # 9
PHOENIX, AZ
ZIP 85044-405
Phone: (901) 757-3643

The provider's authorized official is Teah Michelle Smith .
The authorized official title is Credentialing Manager and has the following contact phone number (901) 205-3999.

The enumeration date for this NPI number is 12/1/2020 and was last updated on 11/13/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			No
2	207QA0505X	Family Medicine	Adult Medicine			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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