Provider Demographics
NPI:1477921088
Name:PALM VALLEY WOMEN'S CARE
Entity Type:Organization
Organization Name:PALM VALLEY WOMEN'S CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ESCARCEGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-512-4466
Mailing Address - Street 1:10815 W MCDOWELL RD STE 301
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-5016
Mailing Address - Country:US
Mailing Address - Phone:623-535-0740
Mailing Address - Fax:623-535-0741
Practice Address - Street 1:10815 W MCDOWELL RD STE 301
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-5016
Practice Address - Country:US
Practice Address - Phone:623-535-0740
Practice Address - Fax:623-535-0741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-14
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN054223174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty