1528169125 NPI number — HONORHEALTH

Table of content: (NPI 1528169125)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528169125 NPI number — HONORHEALTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HONORHEALTH
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:
1528169125
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/16/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 845635
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90084-5635
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
623-683-7673
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19829 N 27TH 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:
85027-4001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
623-879-6100
Provider Business Practice Location Address Fax Number:
623-879-5400
Provider Enumeration Date:
09/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HENDRIX
Authorized Official First Name:
JENIFER
Authorized Official Middle Name:
Authorized Official Title or Position:
SENIOR NETWORK DIRECTOR
Authorized Official Telephone Number:
623-683-4503

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  H0167 , 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: 446246 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 860117301 . This is a "AZ FOUNDATION FOR MED CAR" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 860117301 . This is a "HEALTH MGMT NETWORK" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 0676381 . This is a "AETNA HEALTH INC." identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 860117301 . This is a "FEDERAL CORRECTIONAL INST" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: AZ0204830 . This is a "BLUE CROSS AZ" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 860117301 . This is a "FIRST HEALTH" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 860117301 . This is a "AZ STATE PHYS ASSOC" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 860117301 . This is a "CHOICE CARE NETWORK" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 860117301 . This is a "ACCOUNTABLE HEALTH PLANS" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 860117301 . This is a "COMMUNITY CARE NETWORK" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 860117301 . This is a "BEECH STREET" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 0000 . This is a "BLUE CROSS TRICARE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 860117301 . This is a "DONOR NETWORK OF AZ" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 860117301 . This is a "AZ DEPT OF JUVENILE CORR" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 860117301 . This is a "CITY OF GLENDALE WORKERS" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".




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