Provider Demographics
NPI:1093791170
Name:HOSPITAL DEVELOPMENT OF WEST PHOENIX INC
Entity Type:Organization
Organization Name:HOSPITAL DEVELOPMENT OF WEST PHOENIX INC
Other - Org Name:ABRAZO WEST CAMPUS AND ABRAZO MARYVALE CAMPUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:ORONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-882-1717
Mailing Address - Street 1:20 BURTON HILLS BLVD
Mailing Address - Street 2:SUITE 100, ATTENTION, SUSAN VAUGHAN
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-6409
Mailing Address - Country:US
Mailing Address - Phone:615-665-6000
Mailing Address - Fax:615-665-6184
Practice Address - Street 1:13677 W MCDOWELL RD
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-2635
Practice Address - Country:US
Practice Address - Phone:623-882-1505
Practice Address - Fax:623-882-1510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-20
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZH3446282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ806416Medicaid
AZ030110Medicare Oscar/Certification
AZZ119462Medicare PIN