Provider Demographics
NPI:1588685572
Name:BARIX CLINICS OF ARIZONA, LLC
Entity Type:Organization
Organization Name:BARIX CLINICS OF ARIZONA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LAURENCE
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:LENZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:ATTORNEY
Authorized Official - Phone:734-547-1153
Mailing Address - Street 1:135 S PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-7914
Mailing Address - Country:US
Mailing Address - Phone:480-538-3000
Mailing Address - Fax:734-547-1145
Practice Address - Street 1:17500 N PERIMETER DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-7808
Practice Address - Country:US
Practice Address - Phone:480-538-3000
Practice Address - Fax:480-538-3009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSH1732284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ030116Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER