OrganizationSouthwest Skin Specialists, Llc(<Unavail>)Clinical Medical LaboratoryLaboratoriesPractice Address5010 E Shea Blvd Ste 130, Scottsdale, AZ 85254-4709(602) 494-1817PECOS EnrollmentBased on the most recent information from CMS, provider Southwest Skin Specialists, Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1609185347Provider TypeOrganizationFull NameSouthwest Skin Specialists, LlcOther Name<Unavail>SubpartNoEnumeration Date9/29/2010Last Updated12/11/2018Contact InformationPractice LocationPractice Address5010 E Shea Blvd Ste 130, Scottsdale, AZ 85254-4709Phone(602) 494-1817Fax(602) 494-7103Mailing LocationMailing Address11130 N Tatum Blvd, Suite 100, Phoenix, AZ 85028-1662Phone(602) 494-1817Fax(602) 494-7103Authorized OfficialNameLuber, Howard J. (Medical Director)Phone(602) 494-1817Provider TaxonomiesCodeDescriptionLicenseCode291U00000XPrimaryDescriptionClinical Medical LaboratoryLaboratoriesLicense98010735ArizonaProvider IdentifiersIDDescriptionIssuerIDWMBJQDescriptionOtherIssuerMEDICARE IDArizona