Provider Demographics
NPI:1548252356
Name:MEDASSURE, INC.
Entity type:Organization
Organization Name:MEDASSURE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-470-9700
Mailing Address - Street 1:1606 E UNIVERSITY DR
Mailing Address - Street 2:101
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85034-6714
Mailing Address - Country:US
Mailing Address - Phone:602-470-9700
Mailing Address - Fax:602-454-6306
Practice Address - Street 1:1606 E UNIVERSITY DR
Practice Address - Street 2:101
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034-6714
Practice Address - Country:US
Practice Address - Phone:602-470-9700
Practice Address - Fax:602-454-6306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-17
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ07513171332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1060890001Medicare NSC