1326015165 NPI number — PATRICIA A ARMSTRONG PA

Table of content: PATRICIA A ARMSTRONG PA (NPI 1326015165)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326015165 NPI number — PATRICIA A ARMSTRONG PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARMSTRONG
Provider First Name:
PATRICIA
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PA
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:
1326015165
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/23/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 29862
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHOENIX
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85038-9862
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
602-433-1822
Provider Business Mailing Address Fax Number:
602-246-7060

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1300 N 12TH ST
Provider Second Line Business Practice Location Address:
301
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85006-2848
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-839-6968
Provider Business Practice Location Address Fax Number:
602-839-4144
Provider Enumeration Date:
03/01/2006

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: 363A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X , with the licence number: 2416 , 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: 72107 . This is a "PIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100612 . This is a "PIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 72105 . This is a "PIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 733619 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 72106 . This is a "PIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 72104 . This is a "PIN" identifier . This identifiers is of the category "OTHER".




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