Provider Demographics
NPI:1346659018
Name:MD BUSINESS SOLUTIONS CORP
Entity Type:Organization
Organization Name:MD BUSINESS SOLUTIONS CORP
Other - Org Name:TEMPE PSYCHIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:PROF
Authorized Official - First Name:ARNOLDO
Authorized Official - Middle Name:PROCELA
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:520-400-8660
Mailing Address - Street 1:445 S 48TH ST
Mailing Address - Street 2:109 C
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281
Mailing Address - Country:US
Mailing Address - Phone:480-945-2558
Mailing Address - Fax:
Practice Address - Street 1:445 S 48TH ST
Practice Address - Street 2:109
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281
Practice Address - Country:US
Practice Address - Phone:480-945-2558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-07
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12985305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ196768Medicaid
AZP0731430OtherBLUE CROSS
AZC45892Medicare UPIN
AZ196768Medicaid
AZZ73761Medicare PIN