1821075631 NPI number — THE VHS ARIZONA IMAGING CENTERS LIMITED PARTNERSHIP

Table of content: (NPI 1821075631)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821075631 NPI number — THE VHS ARIZONA IMAGING CENTERS LIMITED PARTNERSHIP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE VHS ARIZONA IMAGING CENTERS LIMITED PARTNERSHIP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ABRAZO ADVANCED IMAGING ARROWHEAD
Provider Other Organization Name Type Code:
3
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:
1821075631
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/03/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20 BURTON HILLS BLVD
Provider Second Line Business Mailing Address:
SUITE 100, ATTN: CAROL BAILEY
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37215-6197
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-665-6000
Provider Business Mailing Address Fax Number:
615-665-6184

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18555 N 79TH AVE
Provider Second Line Business Practice Location Address:
SUITE C-104
Provider Business Practice Location Address City Name:
GLENDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85308-8370
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
623-334-2500
Provider Business Practice Location Address Fax Number:
623-334-3240
Provider Enumeration Date:
12/22/2005

Additional Information

Authorized Official

Authorized Official Last Name:
BAILEY
Authorized Official First Name:
CAROL
Authorized Official Middle Name:
A
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
615-665-6000

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  OTC 4140 , 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: 574948 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".




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