1487792180 NPI number — OSBORN SCHOOL DISTRICT

Table of content: HEATHER HUGHES MCCARTHY NP (NPI 1457752529)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487792180 NPI number — OSBORN SCHOOL DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OSBORN SCHOOL DISTRICT
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:
1487792180
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/25/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1226 W OSBORN RD
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:
85013-3618
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
602-707-2007
Provider Business Mailing Address Fax Number:
602-707-2070

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1226 W. OSBORN ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHONIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85013-3618
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-707-2007
Provider Business Practice Location Address Fax Number:
602-707-2070
Provider Enumeration Date:
02/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MCNANY
Authorized Official First Name:
REBECCA
Authorized Official Middle Name:
Authorized Official Title or Position:
MEDICAID COORDINATOR
Authorized Official Telephone Number:
602-707-2007

Provider Taxonomy Codes

  • Taxonomy code: 251300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251300000X , 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: 552077 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".




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