Provider Demographics
NPI:1043855380
Name:HONORHEALTH AMBULATORY
Entity Type:Organization
Organization Name:HONORHEALTH AMBULATORY
Other - Org Name:SCOTTSDALE HEALTHCARE CORP
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:SVP
Authorized Official - Prefix:
Authorized Official - First Name:SAVAS
Authorized Official - Middle Name:
Authorized Official - Last Name:PETRIDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-696-4020
Mailing Address - Street 1:2500 W UTOPIA RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-4171
Mailing Address - Country:US
Mailing Address - Phone:480-587-5314
Mailing Address - Fax:
Practice Address - Street 1:10210 N 92ND ST STE 101
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4523
Practice Address - Country:US
Practice Address - Phone:602-861-1168
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-11
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Multi-Specialty