Provider Demographics
NPI:1437350790
Name:CONTEMPORARY CARE FOR WOMEN
Entity Type:Organization
Organization Name:CONTEMPORARY CARE FOR WOMEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:GOETZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-820-6657
Mailing Address - Street 1:2550 E GUADALUPE RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-5114
Mailing Address - Country:US
Mailing Address - Phone:480-820-6657
Mailing Address - Fax:
Practice Address - Street 1:6301 S MCCLINTOCK DR
Practice Address - Street 2:SUITE 215
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-3392
Practice Address - Country:US
Practice Address - Phone:480-820-6657
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ63953OtherMEDICARE GROUP ID
AZ63953OtherMEDICARE GROUP ID
AZH00892Medicare UPIN
AZD63955Medicare UPIN
AZC99884Medicare UPIN
AZG93854Medicare UPIN
AZC99863Medicare UPIN