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COUNTRY DOCTOR INC
NPI 1821550310
Clinic/Center - Primary Care in Peoria, AZ

Active since April 03, 2019
13260 N 94TH DR STE 102, PEORIA, AZ 85381(623) 815-0827(623) 875-0325 Get Directions Write a Review

NPPES record last updated: April 11, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 11, 2019, Apr 3, 2019 (2 updates tracked since 2019).

About Country Doctor Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COUNTRY DOCTOR INC (NPI 1821550310) is a healthcare organization registered as a primary care in Peoria, Arizona and active in the NPI registry since April 2019. The organization lists Paul Lee Manganelli, President, as its authorized official.

NPPES Registry Identity

NPI1821550310
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameCOUNTRY DOCTOR INC
Location Address13260 N 94TH DR STE 102Peoria, AZ 85381-4242
Mailing Address13260 N 94th Dr Ste 102Peoria, AZ 85381-4242 · (623) 815-0827 · Fax (623) 875-0325
Phone(623) 815-0827
Fax(623) 875-0325
Organization SubpartNo
Authorized OfficialPaul Lee ManganelliPresident · (623) 815-0827
Enumeration DateApril 3, 2019
Last NPPES UpdateApril 11, 20192 updates tracked since enumeration
✔ NPI 1821550310 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
13260 N 94TH DR STE 102, Peoria, AZ 85381
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Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. THOMAS SHAW PHARM.D.
Pharmacist
13260 N 94TH DR STE 102
PEORIA, AZ 85381
Maricopa County (623) 583-2045
SONORAN DRUGS
Pharmacy (Community/Retail Pharmacy)
13260 N 94TH DR STE 102
PEORIA, AZ 85381
Maricopa County (602) 509-2863
TAMMY ELIZABETH MANGANELLI DNP
Nurse Practitioner (Family)
13260 N 94TH DR STE 102
PEORIA, AZ 85381
Maricopa County (623) 815-0827

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Country Doctor Inc's NPI number?

The NPI number for Country Doctor Inc is 1821550310. It was assigned to this organization in the NPPES registry on April 3, 2019.

Where is Country Doctor Inc located?

Country Doctor Inc is located at 13260 N 94th Dr Ste 102, Peoria, AZ 85381. The listed phone number is (623) 815-0827.

What is Country Doctor Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

When was this NPI record last updated?

The NPPES record for Country Doctor Inc was last updated on April 11, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.