Provider Demographics
NPI:1093858003
Name:SUN VALLEY URGENT CARE
Entity Type:Organization
Organization Name:SUN VALLEY URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOJO
Authorized Official - Middle Name:
Authorized Official - Last Name:HOERTIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-935-7788
Mailing Address - Street 1:17215 NORTH 72ND DRIVE
Mailing Address - Street 2:SUITE C-125
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308
Mailing Address - Country:US
Mailing Address - Phone:623-935-7788
Mailing Address - Fax:623-935-7790
Practice Address - Street 1:2910 N. LITCHFIELD ROAD
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395
Practice Address - Country:US
Practice Address - Phone:623-218-6907
Practice Address - Fax:623-935-7790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty