Provider Demographics
NPI:1518588698
Name:CITY OF TEMPE
Entity Type:Organization
Organization Name:CITY OF TEMPE
Other - Org Name:TEMPE COMMUNITY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:DARRELL
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:DUTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-234-0892
Mailing Address - Street 1:1400 E APACHE BLVD
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-5921
Mailing Address - Country:US
Mailing Address - Phone:480-585-7200
Mailing Address - Fax:
Practice Address - Street 1:1400 E APACHE BLVD
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-5921
Practice Address - Country:US
Practice Address - Phone:480-585-7200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF TEMPE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-04-30
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health