Provider Demographics
NPI:1578198453
Name:HARMONY PHYSICIAN GROUP AN ARIZONA NONPROFIT CORPORPORATION
Entity Type:Organization
Organization Name:HARMONY PHYSICIAN GROUP AN ARIZONA NONPROFIT CORPORPORATION
Other - Org Name:HARMONY MEDICAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEREMIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:FABER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-366-4489
Mailing Address - Street 1:PO BOX 964
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85299-0964
Mailing Address - Country:US
Mailing Address - Phone:480-366-4489
Mailing Address - Fax:480-854-3618
Practice Address - Street 1:81 W GUADALUPE RD STE 112
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-3321
Practice Address - Country:US
Practice Address - Phone:480-664-3840
Practice Address - Fax:602-635-3683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-11
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty