Provider Demographics
NPI:1417979899
Name:CARL T. HAYDEN VA MEDICAL CENTER
Entity Type:Organization
Organization Name:CARL T. HAYDEN VA MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INPATIENT CLINICAL PHARMACY TECH
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CELAYA
Authorized Official - Suffix:
Authorized Official - Credentials:CPHT
Authorized Official - Phone:602-277-5551
Mailing Address - Street 1:14925 N 153RD AVE
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85379-7022
Mailing Address - Country:US
Mailing Address - Phone:623-544-9070
Mailing Address - Fax:602-222-2603
Practice Address - Street 1:650 E. INDIAN SCHOOL ROAD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012
Practice Address - Country:US
Practice Address - Phone:602-277-5551
Practice Address - Fax:602-222-2603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ286500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital