Provider Demographics
NPI:1578874533
Name:ARIZONA FAMILY CARE ASSOCIATES IMAGING LLC
Entity Type:Organization
Organization Name:ARIZONA FAMILY CARE ASSOCIATES IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FRED
Authorized Official - Middle Name:B
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:520-458-4335
Mailing Address - Street 1:6 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-1830
Mailing Address - Country:US
Mailing Address - Phone:520-458-4335
Mailing Address - Fax:520-458-2988
Practice Address - Street 1:302 EL CAMINO REAL
Practice Address - Street 2:SUITE 11F
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-2860
Practice Address - Country:US
Practice Address - Phone:520-417-4318
Practice Address - Fax:520-417-4279
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARIZONA FAMILY CARE ASSOCIATES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-24
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology