Provider Demographics
NPI:1497060966
Name:VHS ARIZONA HEART INSTITUTE INC
Entity Type:Organization
Organization Name:VHS ARIZONA HEART INSTITUTE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SHALEN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-561-7728
Mailing Address - Street 1:20 BURTON HILLS BLVD
Mailing Address - Street 2:ATTN: CAROL BAILEY
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-6197
Mailing Address - Country:US
Mailing Address - Phone:615-665-6000
Mailing Address - Fax:615-665-6184
Practice Address - Street 1:708 S. COEUR D'ALENE DRIVE
Practice Address - Street 2:SUITE B, LOWER LEVEL
Practice Address - City:PAYSON
Practice Address - State:AZ
Practice Address - Zip Code:85541-5662
Practice Address - Country:US
Practice Address - Phone:928-474-2175
Practice Address - Fax:928-474-9424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-09
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ561960Medicaid
AZZ141252Medicare PIN