Individual ProviderJon VimmerstedtStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address18701 N 67th Ave, Glendale, AZ 85308-7100(623) 561-1000PECOS EnrollmentBased on the most recent information from CMS, provider Jon Vimmerstedt 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 6 days ago.Profile DetailsProvider ID1649019076Provider TypeIndividualFull NameVimmerstedt, JonCredentialDOGenderMaleSole ProprietorYesEnumeration Date5/24/2024Last Updated5/24/2024Contact InformationPractice LocationPractice Address18701 N 67th Ave, Glendale, AZ 85308-7100Phone(623) 561-1000FaxUnlisted FaxMailing LocationMailing Address1641 E Aurelius Ave, Phoenix, AZ 85020-5559PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted IssuerCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted IssuerArizona