Provider Demographics
NPI:1093868812
Name:HONORHEALTH
Entity Type:Organization
Organization Name:HONORHEALTH
Other - Org Name:FAMILY PRACTICE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR NETWORK DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDRIX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-683-4503
Mailing Address - Street 1:2500 W UTOPIA RD STE 100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-4172
Mailing Address - Country:US
Mailing Address - Phone:480-587-5314
Mailing Address - Fax:480-882-5874
Practice Address - Street 1:7301 E 2ND ST
Practice Address - Street 2:SUITE #210
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-5600
Practice Address - Country:US
Practice Address - Phone:480-882-4545
Practice Address - Fax:480-946-6997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZF01629OtherPHOENIX HEALTH PLAN
AZCE1661OtherMEDICARE RAILROAD
AZZWCHPZMedicare PIN