1821397787 NPI number — CIGNA HEALTHCARE OF ARIZONA, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821397787 NPI number — CIGNA HEALTHCARE OF ARIZONA, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CIGNA HEALTHCARE OF ARIZONA, INC.
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:
Provider Other Organization Name Type Code:
6
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:
1821397787
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/21/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8888 E RAINTREE DR FL 3
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCOTTSDALE
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85260-3951
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
602-328-8400
Provider Business Mailing Address Fax Number:
623-277-1091

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
36305 N GANTZEL RD
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
QUEEN CREEK
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85140-7325
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-987-6900
Provider Business Practice Location Address Fax Number:
480-987-6905
Provider Enumeration Date:
03/17/2011

Additional Information

Authorized Official

Authorized Official Last Name:
BHARDWAJA
Authorized Official First Name:
POOJA
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF MEDICAL OFFICER
Authorized Official Telephone Number:
480-239-5812

Provider Taxonomy Codes

  • Taxonomy code: 261QM1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000 . This is a "NOT YET IDENTIFIED" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".




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