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Randall Lee Piette

Internal Medicine

Allopathic & Osteopathic Physicians

10503 W Thunderbird Blvd Ste 262, Sun City, AZ 85351-3048

PECOS Enrollment

This provider is enrolled in PECOS as RANDALL PIETTE.

Based on the most recent information from CMS, provider Randall Lee Piette is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1154314243
Provider Type
Individual
Full Name
Piette, Randall Lee
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
8/24/2005
Last Updated
11/24/2009

Contact Information

Practice Location

10503 W Thunderbird Blvd Ste 262, Sun City, AZ 85351-3048

(623) 933-8289

(623) 933-2596

Mailing Location

10503 W Thunderbird Blvd Ste 262, Sun City, AZ 85351-3048

(623) 933-8289

(623) 933-2596

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License H08789 Arizona

Provider Identifiers

ID	Description	Issuer
ID AZ0870900	Description Other	Issuer BLUE CROSS BLUE SHIELD Arizona
ID 110203682	Description Other	Issuer RAILROAD MEDICARE Arizona

Randall Lee Piette

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

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