Provider Demographics
NPI:1578976379
Name:ARIZONA ONCOLOGY ASSOCIATES PC
Entity Type:Organization
Organization Name:ARIZONA ONCOLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER PHARMACY OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:PENDLETON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:520-390-6189
Mailing Address - Street 1:2625 N CRAYCROFT RD STE 221
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-2268
Mailing Address - Country:US
Mailing Address - Phone:520-390-6189
Mailing Address - Fax:520-519-7910
Practice Address - Street 1:2625 N CRAYCROFT RD STE 200B
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2268
Practice Address - Country:US
Practice Address - Phone:520-416-5744
Practice Address - Fax:602-476-5156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-09
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No332900000XSuppliersNon-Pharmacy Dispensing SiteGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0359491OtherNCPDP
AZ289515Medicaid
AZ7205350005Medicare NSC
AZ289515Medicaid