Westridge Medical Group LLC
General Practice in Hendersonville, NC. Organization (NPI-2).
NPI number1982249496
StatusActive
Last updated in NPPESAug 19, 2021
Details
- NPI
- 1982249496
- Entity type
- Organization (NPI-2)
- Legal business name
- Westridge Medical Group LLC
- Organization subpart
- No
- Enumeration date
- Nov 8, 2019
- Certification date
- Aug 19, 2021
- Last updated
- Aug 19, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | – | – | Yes |
| 225100000X | Physical Therapist | – | – | |
| 363LF0000X | Nurse Practitioner, Family | – | – | |
| 111NR0400X | Chiropractor, Rehabilitation | – | – | |
| 207Q00000X | Family Medicine | – | – |
Practice location
1721 Brevard RdHendersonville, NC 28791-3201
Phone 480-926-7800 · Fax 480-926-2260
Mailing address
2250 E Germann Rd Ste 8Chandler, AZ 85286-1575
Phone 480-926-7800 · Fax 480-926-2260
Authorized official
Ellie Descalzo
Credentialing Officer
4809267800
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