1972628675 NPI number — ARIZONA ONCOLOGY SERVICES INC

Table of content: (NPI 1972628675)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972628675 NPI number — ARIZONA ONCOLOGY SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARIZONA ONCOLOGY SERVICES 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:
ARIZONA ONCOLOGY SERVICES
Provider Other Organization Name Type Code:
5
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:
1972628675
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/09/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
02/23/2011
NPI Reactivation Date:
03/09/2011

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 W CLARENDON
Provider Second Line Business Mailing Address:
SUITE 350
Provider Business Mailing Address City Name:
PHOENIX
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85013
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
602-274-4484
Provider Business Mailing Address Fax Number:
602-287-9406

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 W CLARENDON
Provider Second Line Business Practice Location Address:
SUITE 350
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-274-4484
Provider Business Practice Location Address Fax Number:
602-287-9406
Provider Enumeration Date:
03/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SPEISER
Authorized Official First Name:
BURTON
Authorized Official Middle Name:
L
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
602-240-3468

Provider Taxonomy Codes

  • Taxonomy code: 2085R0001X , with the licence number:  11736 , 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: Z105955 . This is a "MEDICARE PTAN NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: Z109650 . This is a "MEDICARE PTAN NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: Z80188 . This is a "MEDICARE PTAN NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: Z101642 . This is a "MEDICARE PTAN NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: Z20516 . This is a "MEDICARE PTAN NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: Z30WCHJD08 . This is a "MEDICARE PTAN NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: ZWCHJD14 . This is a "MEDICARE PTAN NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: Z105956 . This is a "MEDICARE PTAN NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: Z76179 . This is a "MEDICARE PTAN NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: ZWCHJD09 . This is a "MEDICARE PTAN NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: ZWCHJD13 . This is a "MEDICARE PTAN NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: Z30WCHJD07 . This is a "MEDICARE PTAN NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: Z29943 . This is a "MEDICARE PTAN NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: Z76882 YUMA . This is a "MEDICARE PTAN NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: ZWCHJD01 . This is a "MEDICARE PTAN NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: Z105957 . This is a "MEDICARE PTAN NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: Z24460 . This is a "MEDICARE PTAN NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: Z109521 . This is a "MEDICARE PTAN NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: Z74768 . This is a "MEDICARE PTAN NUMBER" identifier . This identifiers is of the category "OTHER".




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