1184612459 NPI number — MRS. KATHERINE A SCHOFIELD OTRL CHT

Table of content: MRS. KATHERINE A SCHOFIELD OTRL CHT (NPI 1184612459)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184612459 NPI number — MRS. KATHERINE A SCHOFIELD OTRL CHT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHOFIELD
Provider First Name:
KATHERINE
Provider Middle Name:
A
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
OTRL CHT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184612459
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/01/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
620 N COFCO CENTER CT
Provider Second Line Business Mailing Address:
STE 260
Provider Business Mailing Address City Name:
PHOENIX
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85008
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
602-279-6905
Provider Business Mailing Address Fax Number:
888-445-4263

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10250 N 92ND ST
Provider Second Line Business Practice Location Address:
STE 112
Provider Business Practice Location Address City Name:
SCOTTSDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85258-4510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-661-7779
Provider Business Practice Location Address Fax Number:
888-445-4263
Provider Enumeration Date:
10/11/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225XH1200X , with the licence number:  0509 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 192071 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: DF7521 . This is a "RAILROAD MEDICARE GROUP NUMBER" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".




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