| Organization Name: | MEDEX HEALTH CARE LLC |
| NPI Number: | 1023201464 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SAMER S SANNOUFI (OWNER) |
| Mailing Address: | 201 W Guadalupe Rd Ste 200 Gilbert |
| State: | AZ US |
| Postal Code: | 852333332 |
| Phone Number: | 4805587078 |
| Fax Number: | 4805587081 |
| NPI Enumeration Date: | 08/20/2007 |
| NPI Last Update Date: | 08/12/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 33024 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |