Provider Demographics
NPI:1740610195
Name:ARIZONA QUALITY CARE PROVIDERS LLC
Entity Type:Organization
Organization Name:ARIZONA QUALITY CARE PROVIDERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:LASKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-264-5003
Mailing Address - Street 1:881 W FOLLEY ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-6219
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:501 W RAY RD
Practice Address - Street 2:SUITE 7
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-7284
Practice Address - Country:US
Practice Address - Phone:480-264-5003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-22
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care