Provider Demographics
NPI: | 1003086190 |
---|---|
Name: | ARIZONA MEDICAL REVIEW OFFICERS, INC. |
Entity Type: | Organization |
Organization Name: | ARIZONA MEDICAL REVIEW OFFICERS, INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | HR DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | HEATHER |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | WAHL |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 602-272-1162 |
Mailing Address - Street 1: | 3501 W OSBORN RD |
Mailing Address - Street 2: | |
Mailing Address - City: | PHOENIX |
Mailing Address - State: | AZ |
Mailing Address - Zip Code: | 85019-4037 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 602-272-7676 |
Mailing Address - Fax: | 602-269-9730 |
Practice Address - Street 1: | 3501 W OSBORN RD |
Practice Address - Street 2: | |
Practice Address - City: | PHOENIX |
Practice Address - State: | AZ |
Practice Address - Zip Code: | 85019-4037 |
Practice Address - Country: | US |
Practice Address - Phone: | 602-272-7676 |
Practice Address - Fax: | 602-269-9730 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2008-03-05 |
Last Update Date: | 2008-07-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
AZ | 3912 | 261QU0200X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QU0200X | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |