1538713482 NPI number — MR. ROONEY BATRUS YOUSIF AAGO RPH

Table of content: MR. ROONEY BATRUS YOUSIF AAGO RPH (NPI 1538713482)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538713482 NPI number — MR. ROONEY BATRUS YOUSIF AAGO RPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AAGO
Provider First Name:
ROONEY
Provider Middle Name:
BATRUS YOUSIF
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
RPH
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538713482
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/19/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7604 W YUCCA ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PEORIA
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85345-1088
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
312-478-6972
Provider Business Mailing Address Fax Number:
602-246-3908

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1607 W BETHANY HOME RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85015-2507
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-246-6601
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/29/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  S024824 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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