Provider Demographics
NPI:1114948239
Name:ARROWHEAD MOBILE HEALTHCARE, INC
Entity Type:Organization
Organization Name:ARROWHEAD MOBILE HEALTHCARE, INC
Other - Org Name:SHOW LOW EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:W
Authorized Official - Last Name:BROOME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-586-7617
Mailing Address - Street 1:PO BOX 1207
Mailing Address - Street 2:
Mailing Address - City:BENSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85602-1207
Mailing Address - Country:US
Mailing Address - Phone:520-586-7617
Mailing Address - Fax:520-586-2689
Practice Address - Street 1:1000 E MILLS
Practice Address - Street 2:
Practice Address - City:SHOW LOW
Practice Address - State:AZ
Practice Address - Zip Code:85901-5916
Practice Address - Country:US
Practice Address - Phone:520-586-7617
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ590013848OtherCHAMPUS
AZAZ0152030OtherBCBS
AZ499360Medicaid
AZAZ0152030OtherBCBS