Family Medicine, Adult Medicine
AGELESS NUTRITION BAR HOLDINGS, INC
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1932704830 · enumerated 2020-12-01 · record updated 2023-11-13. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: TEAH SMITH, Credentialing Manager · (901) 205-3999
Other names: AGELESS MEN'S HEALTH
Addresses and phones
- Practice location 4802 E RAY RD # 9, PHOENIX, AZ, 85044-6405 (901) 757-3643 Google Maps Apple Maps OpenStreetMap
- Mailing address 4802 E RAY RD # 9, PHOENIX, AZ, 85044-6405 Google Maps Apple Maps OpenStreetMap
Specialties
- Clinic/Center, Primary Care 261QP2300X
- Family Medicine, Adult Medicine 207QA0505X · Primary
In this directory
Locations and evidence
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Practice location
PHOENIX, AZ, 850446405
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.