Provider Demographics
NPI:1609496397
Name:FHMC LLC
Entity type:Organization
Organization Name:FHMC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MEKA
Authorized Official - Middle Name:N
Authorized Official - Last Name:EZEUME
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-214-8061
Mailing Address - Street 1:PO BOX 248959
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73124-8959
Mailing Address - Country:US
Mailing Address - Phone:480-339-4825
Mailing Address - Fax:602-883-7330
Practice Address - Street 1:9700 N SAGUARO BLVD
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-6241
Practice Address - Country:US
Practice Address - Phone:602-671-7990
Practice Address - Fax:602-755-0456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-22
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ090640Medicaid
AZOTC10792OtherAZ DEPARTMENT OF HEALTH SERVICES - OUTPATIENT TREATMENT CENTER