Provider Demographics
NPI:1902504921
Name:BEMBENEK TRAVEL HEALTH OR
Entity Type:Organization
Organization Name:BEMBENEK TRAVEL HEALTH OR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHBURN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-646-9020
Mailing Address - Street 1:4343 EAST OUTLIER BLV
Mailing Address - Street 2:SUITE 100W
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-6507
Mailing Address - Country:US
Mailing Address - Phone:844-358-8648
Mailing Address - Fax:877-877-6875
Practice Address - Street 1:1020 SW TAYLOR ST
Practice Address - Street 2:SUITE 740
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205
Practice Address - Country:US
Practice Address - Phone:844-358-8648
Practice Address - Fax:877-877-6875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty