FOUR PEAKS PAIN CENTER – NPI #1760960405
Clinic/Center

FOUR PEAKS PAIN CENTER is an AHC clinic located in MESA, AZ. NPPES has assigned the NPI number 1760960405 to FOUR PEAKS PAIN CENTER on August 03, 2018. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “FOUR PEAKS PAIN CENTER” is a dba name, the actual legal business name for this organization is BERTHA, LLC. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was previously updated about 8 years ago on Oct 23, 2018. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for FOUR PEAKS PAIN CENTER below.

NPI Profile for
BERTHA, LLC

NPI Number
1760960405
Enumeration Date

(about 8 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BERTHA, LLC
Doing Business As (dba): FOUR PEAKS PAIN CENTER
Primary location
3850 E BASELINE RD STE 117
MESA, AZ 85206-4404
Phone: (480) 712-6663 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
CORINNE KOVAC
MANAGER
Phone: (480) 712-6663
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.