Provider Demographics
NPI:1073938817
Name:URGENT CARE CENTERS OF ARIZONA, LLC
Entity Type:Organization
Organization Name:URGENT CARE CENTERS OF ARIZONA, LLC
Other - Org Name:MEDPOST URGENT CARE LAVEEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP OF OUTPATIENT SERVICES, TENET
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:KYLE
Authorized Official - Last Name:BURTNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-893-2153
Mailing Address - Street 1:PO BOX 59721
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-9721
Mailing Address - Country:US
Mailing Address - Phone:602-237-7373
Mailing Address - Fax:602-237-7977
Practice Address - Street 1:5130 W BASELINE RD
Practice Address - Street 2:
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-2984
Practice Address - Country:US
Practice Address - Phone:602-237-7373
Practice Address - Fax:602-237-7977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-04
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care