Provider Demographics
NPI:1093385031
Name:MARICOPA COUNTY SPECIAL HEALLTH CARE DISTRICT
Entity Type:Organization
Organization Name:MARICOPA COUNTY SPECIAL HEALLTH CARE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOGARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-344-5253
Mailing Address - Street 1:2601 E ROOSEVELT ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-4973
Mailing Address - Country:US
Mailing Address - Phone:602-344-5011
Mailing Address - Fax:
Practice Address - Street 1:7808 W THOMAS ROAD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85033
Practice Address - Country:US
Practice Address - Phone:602-344-1338
Practice Address - Fax:602-344-1163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ20107Medicaid