1194709089 NPI number — VHS ACQUISITION COMPANY NUMBER 1 LLC

Table of content: (NPI 1194709089)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194709089 NPI number — VHS ACQUISITION COMPANY NUMBER 1 LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VHS ACQUISITION COMPANY NUMBER 1 LLC
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:
PHOENIX MEMORIAL HOSPITAL
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:
1194709089
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 STE 100
Provider Second Line Business Mailing Address:
ATTENTION: CAROL BAILEY
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37215-6409
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:
1201 S 7TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85007-3913
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-824-3324
Provider Business Practice Location Address Fax Number:
602-824-3383
Provider Enumeration Date:
12/03/2005

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: 282N00000X , with the licence number:  H3425 , 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: 817687 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".