Provider Demographics
NPI:1033649876
Name:FAMILY KARE WALK-IN KLINIC LLC
Entity Type:Organization
Organization Name:FAMILY KARE WALK-IN KLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUZ
Authorized Official - Middle Name:A
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-252-1439
Mailing Address - Street 1:521 W THOMAS RD FL 2
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-4241
Mailing Address - Country:US
Mailing Address - Phone:602-242-5000
Mailing Address - Fax:888-846-8757
Practice Address - Street 1:521 W THOMAS RD FL 2
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4241
Practice Address - Country:US
Practice Address - Phone:602-242-5000
Practice Address - Fax:888-846-8757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ238928Medicaid
AZ978254Medicaid
AZ072978Medicaid
AZ601547Medicaid
AZ016438Medicaid
AZ12650354Medicaid
AZ921545Medicaid
AZ928666Medicaid